Percutaneous Cholecystostomy is a Reasonable Alternative for the Treatment of Acute Cholecystitis in Critically Ill Patients: a Single Center Analysis

Background / objective. Laparoscopic cholecystectomy is a safe procedure and the treatment of choice for acute cholecystitis. As an alternative treatment option in critically ill patients percutaneous cholecystostomy (PC) is performed.Methods. Retrospective review of patients who had undergone PC from 2008 to 2017 at the Department of Surgery, Hospital of Lithuanian University of Health Sciences Kaunas Clinics. Patients were reviewed for demographic features, laboratory tests, ASA class, complications, outcomes, hospital stay and mortality rate.Results. Fifty-four patients were included in the study. Forty patients (74%) were ASA III and ten patients (18.5%) – ASA IV. Statistically significant decrease in white blood cell count (from 14.26±6.61 to 8.65±5.15) and C-reactive protein level (from 226.22±106.60 to 51.91±63.70) following PC was observed. The median hospital stay was 13.06 (range 2–68) days and 30-day mortality rate 13%. There were no deaths directly related to procedure. For eleven patients (20.4%) delayed cholecystectomy was scheduled.Conclusions. PC is a reasonable treatment option for high-risk patients with acute cholecystitis and co-morbidities. It can be used as a temporizing treatment option or as a definitive treatment with a low number of delayed cholecystectomies.

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Percutaneous Cholecystostomy Is Appropriate as Definitive Treatment for Acute Cholecystitis in Critically Ill Patients: A Single Center, Cross-sectional Study

Korean Journal of Gastroenterology ◽

10.4166/kjg.2014.63.1.32 ◽

2014 ◽

Vol 63 (1) ◽

pp. 32 ◽

Cited By ~ 18

Author(s):

Byung Hyo Cha ◽

Ha Hun Song ◽

Young Nam Kim ◽

Won Jung Jeon ◽

Sang Jin Lee ◽

...

Keyword(s):

Acute Cholecystitis ◽

Critically Ill ◽

Critically Ill Patients ◽

Cross Sectional Study ◽

Definitive Treatment ◽

Percutaneous Cholecystostomy ◽

Sectional Study ◽

Single Center ◽

Cross Sectional

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Percutaneous Cholecystostomy Without Interval Cholecystectomy as Definitive Treatment of Acute Cholecystitis in Elderly and Critically Ill Patients

Southern Medical Journal ◽

10.1097/smj.0b013e3181757b77 ◽

2008 ◽

Vol 101 (6) ◽

pp. 586-590 ◽

Cited By ~ 64

Author(s):

John Griniatsos ◽

Athanasios Petrou ◽

Paris Pappas ◽

Konstantinos Revenas ◽

Ioannis Karavokyros ◽

...

Keyword(s):

Acute Cholecystitis ◽

Critically Ill ◽

Critically Ill Patients ◽

Definitive Treatment ◽

Percutaneous Cholecystostomy

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Percutaneous cholecystostomy: a nonsurgical therapeutic option for acute cholecystitis in high-risk and critically ill patients

Sao Paulo Medical Journal ◽

10.1590/s1516-31802003000600009 ◽

2003 ◽

Vol 121 (6) ◽

pp. 260-262 ◽

Cited By ~ 9

Author(s):

Guilherme de Castro Dabus ◽

Sérgio San Juan Dertkigil ◽

Jamal Baracat

Keyword(s):

High Risk ◽

Acute Cholecystitis ◽

Critically Ill ◽

Critically Ill Patients ◽

Therapeutic Option ◽

Invasive Procedure ◽

Acalculous Cholecystitis ◽

Definitive Treatment ◽

Distinct Advantage ◽

Percutaneous Cholecystostomy

Percutaneous cholecystostomy offers a potentially important type of therapy for critically ill patients with acute cholecystitis who present high risk when undergoing laparotomy or laparoscopy under general anesthesia. It offers a distinct advantage for these kinds of patients by avoiding the risks of the surgical intervention. Percutaneous cholecystostomy is a safe and effective minimally invasive procedure with a high success rate and low procedure-related complications. It should be considered not only in temporary management of calculous cholecystitis, but also in definitive treatment in cases of acalculous cholecystitis.

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Tu1777 Clinical Outcomes of Percutaneous Cholecystostomy Tube Placement in Critically Ill Patients With Acute Cholecystitis

Gastroenterology ◽

10.1016/s0016-5085(15)34025-7 ◽

2015 ◽

Vol 148 (4) ◽

pp. S-1180

Author(s):

Kenneth Sirinek ◽

Ronald M. Stewart ◽

Kent Van Sickle ◽

Wayne Schwesinger

Keyword(s):

Acute Cholecystitis ◽

Clinical Outcomes ◽

Critically Ill ◽

Critically Ill Patients ◽

Tube Placement ◽

Percutaneous Cholecystostomy ◽

Cholecystostomy Tube ◽

Percutaneous Cholecystostomy Tube

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Percutaneous cholecystostomy in critically ill patients with acute cholecystitis: Complications and late outcome

Clinical Radiology ◽

10.1016/j.crad.2014.01.012 ◽

2014 ◽

Vol 69 (6) ◽

pp. e247-e252 ◽

Cited By ~ 32

Author(s):

E. Atar ◽

G.N. Bachar ◽

S. Berlin ◽

C. Neiman ◽

E. Bleich-Belenky ◽

...

Keyword(s):

Acute Cholecystitis ◽

Critically Ill ◽

Critically Ill Patients ◽

Percutaneous Cholecystostomy ◽

Late Outcome

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Cholecystectomy vs. percutaneous cholecystostomy for the management of critically ill patients with acute cholecystitis: a protocol for a systematic review

Systematic Reviews ◽

10.1186/s13643-015-0065-8 ◽

2015 ◽

Vol 4 (1) ◽

Cited By ~ 7

Author(s):

Peter C. Ambe ◽

Sarantos Kaptanis ◽

Marios Papadakis ◽

Sebastian A. Weber ◽

Hubert Zirngibl

Keyword(s):

Systematic Review ◽

Acute Cholecystitis ◽

Critically Ill ◽

Critically Ill Patients ◽

Percutaneous Cholecystostomy

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Cholecystostomy as Bridge to Surgery and as Definitive Treatment or Acute Cholecystectomy in Patients with Acute Cholecystitis

Gastroenterology Research and Practice ◽

10.1155/2016/3672416 ◽

2016 ◽

Vol 2016 ◽

pp. 1-6 ◽

Cited By ~ 8

Author(s):

Agnieszka Popowicz ◽

Lars Lundell ◽

Peter Gerber ◽

Ulf Gustafsson ◽

Emil Pieniowski ◽

...

Keyword(s):

Standard Deviation ◽

Hospital Stay ◽

Acute Cholecystitis ◽

Medical Records ◽

Definitive Treatment ◽

Bridge To Surgery ◽

Percutaneous Cholecystostomy ◽

Stockholm County ◽

Number Of Patients ◽

Comorbidity Index

Purpose.Percutaneous cholecystostomy (PC) has increasingly been used as bridge to surgery as well as sole treatment for patients with acute cholecystitis (AC). The aim of the study was to assess the outcome after PC compared to acute cholecystectomy in patients with AC.Methods.A review of medical records was performed on all patients residing in Stockholm County treated for AC in the years 2003 and 2008.Results.In 2003 and 2008 altogether 799 and 833 patients were admitted for AC. The number of patients treated with PC was 21/799 (2.6%) in 2003 and 50/833 (6.0%) in 2008. The complication rate (Clavien-Dindo ≥ 2) was 4/71 (5.6%) after PC and 135/736 (18.3%) after acute cholecystectomy. Mean (standard deviation) hospital stay was 11.4 (10.5) days for patients treated with PC and 5.1 (4.3) days for patients undergoing acute cholecystectomy. After adjusting for age, gender, Charlson comorbidity index, and degree of cholecystitis, the hospital stay was significantly longer for patients treated with PC than for those undergoing acute cholecystectomy (P<0.001) but the risk for intervention-related complications was found to be significantly lower (P=0.001) in the PC group.Conclusion.PC can be performed with few serious complications, albeit with a longer hospital stay.

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