Percutaneous Cholecystostomy
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Author(s):  
Alexander Ostapenko ◽  
Shawn Liechty ◽  
Emi Manuia ◽  
Stephanie Stroever ◽  
Marc Casasanta ◽  
...  

2021 ◽  
Vol 5 ◽  
pp. 13
Author(s):  
Austin Snyder ◽  
Silvia Salamone ◽  
Nicholas J. Reid ◽  
Tristan Yeung ◽  
John Di Capua ◽  
...  

Objectives: During the COVID-19 pandemic, there was a perceived increase in the number of cholecystostomy tube placements. We have retrospectively analyzed the incidence and outcomes of cholecystostomy tube placement during the COVID-19 pandemic surge. Material and Methods: Cholecystostomy tube placement and overall interventional radiology (IR) case volume were analyzed at our tertiary care center during the pandemic (March 15, 2020–July 30, 2020) and compared to the same time period in 2019. In addition, an age- and gender-matched control study of outcomes for 40 patients (25 from our home institution and 15 from our affiliated hospitals) grouped by COVID-19 status who received percutaneous cholecystostomy tubes between March 15, 2020, and July 30, 2020, was performed. Results: We observed a significant increase in relative cholecystostomy tube volume during the pandemic, despite a decrease in total IR case volume. There was no significant difference in pre- or post-procedural laboratory data, vital signs, imaging, or mortality between COVID-positive and COVID-negative patients who received cholecystostomy tubes. Conclusion: Percutaneous cholecystostomy tube placement is likely a safe treatment for acalculous cholecystitis in patients with COVID-19 with equivalent outcomes to patients without COVID-19.


2021 ◽  
Vol 38 (03) ◽  
pp. 330-339
Author(s):  
Matthew Antalek ◽  
Ahsun Riaz ◽  
Albert A. Nemcek

AbstractPercutaneous cholecystostomy is an established procedure for the management of patients with acute cholecystitis and with significant medical comorbidities that would make laparoscopic cholecystectomy excessively risky. In this review, we will explore the role of percutaneous cholecystostomy in the management of acute cholecystitis as well as other applications in the management of biliary pathology. The indications, grading, technical considerations, and postprocedure management in the setting of acute cholecystitis are discussed. In addition, we will discuss the potential role of percutaneous cholecystostomy in the management of gallstones and biliary strictures, in establishing internal biliary drainage, and in a joint setting with other clinicians such as gastroenterologists in the management of complex biliary pathology.


Author(s):  
Kumble Seetharama Madhusudhan ◽  
Valakkada Jineesh ◽  
Shyamkumar Nidugala Keshava

AbstractPercutaneous biliary interventions are among the commonly performed nonvascular radiological interventions. Most common of these interventions is the percutaneous transhepatic biliary drainage for malignant biliary obstruction. Other biliary procedures performed include percutaneous cholecystostomy, biliary stenting, drainage for bile leaks, and various procedures like balloon dilatation, stenting, and large-bore catheter drainage for bilioenteric or post-transplant anastomotic strictures. Although these procedures are being performed for ages, no standard guidelines have been formulated. This article attempts at preparing guidelines for performing various percutaneous image-guided biliary procedures along with discussion on the published evidence in this field.


2021 ◽  
Author(s):  
Yao Peng ◽  
Zhihui Chang ◽  
Zhaoyu Liu

Abstract Background: Percutaneous cholecystostomy (PC) with interval cholecystectomy is an effective treatment modality in high-risk patients with acute cholecystitis. However, some patients still fail to undergo interval cholecystectomy after PC, with the reasons rarely reported. Hence, this study aimed to explore the factors that prevent a patient from undergoing interval cholecystectomy.Methods: Data from patients with acute cholecystitis who had undergone PC from January 1, 2017, to December 31, 2019, in our hospital were retrospectively collected. The follow-up endpoint was the patient undergoing cholecystectomy. Patients who failed to undergo cholecystectomy were followed up every three months until death. Univariate and multivariate analyses were performed to analyze the factors influencing failure to undergo interval cholecystectomy. A nomogram was used to predict the numerical probability of non-interval cholecystectomy.Results: In total, 205 participants were identified, and 67 (32.7%) patients did not undergo cholecystectomy during the follow-up period. Multivariate analysis revealed that Tokyo guidelines 2018 (TG18) grade III status (odds ratio [OR]: 3.83; 95% confidence interval [CI]: 1.27–11.49; p=0.017), acalculous cholecystitis (OR: 4.55; 95% CI: 1.59–12.50; p=0.005), albumin level <28 g/L (OR: 4.15; 95% CI: 1.09–15.81; p=0.037), and history of malignancy (OR: 4.65; 95% CI: 1.62–13.37; p=0.004) were independent risk factors for a patient’s failure to undergo interval cholecystectomy. Among them, history of malignancy showed the highest predictor point on the nomogram for predicting non-interval cholecystectomy.Conclusions: TG18 grade III status, acalculous cholecystitis, severe hypoproteinemia, and history of malignancy are the factors influencing failure to undergo cholecystectomy after PC in patients with acute cholecystitis.


2021 ◽  
Author(s):  
BHAVIN VASAVADA ◽  
Hardik Patel

Abstract Introduction: This meta-analysis aimed to evaluate outcomes of early versus late cholecystectomy after percutaneous cholecystostomy.Methods:The study was conducted according to the PRISMA statement and MOOSE guidelines. Heterogeneity was measured using Q tests and I2 statistics. The random-effects model was used.Results: Six studies including 18640 patients were included in the final analysis. There was no difference in overall complications within or after 72 hours cholecystectomy group, but mortality and biliary complications were significantly high in the less than 72 hours group (p=0.05 and 0.0002 respectively). There was no difference in mortality, overall complication, biliary tract complications in less than 1 week versus more than 1 week and less than 10 days versus more than 10 days group. Overall complications were significantly less in the less than 2 weeks group compared to the more than 2 weeks group. There was no difference in mortality and biliary tract complications between less than 2 weeks and more than 2 weeks group. Overall complication rate (risk ratio 0.67, p <0.0001), postoperative mortality (risk ratio 0.46, p=0.003), bile duct injury (risk ratio 0.62, p=0.01) was significantly less in earlier than 4-week group. Hospital stay was not significantly different between less than 4 weeks versus more than 4 weeks group. (Mean difference= -2.74, p=0.12). Ove all complication rates were significantly more in less than 8 weeks group. (Risk ratio 1.07, p=0.01).Conclusion:Early cholecystectomy preferably within 4 weeks after percutaneous cholecystostomy is preferable.


2021 ◽  
Author(s):  
BHAVIN VASAVADA ◽  
Hardik Patel

Introduction: There is a controversy about the optimum timing of cholecystectomy after percutaneous cholecystostomy. This systematic review and meta-analysis aimed to evaluate outcomes of early versus late cholecystectomy after percutaneous cholecystectomy. Methods: The study was conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement and MOOSE guidelines. Heterogeneity was measured using Q tests and I2 statistics. The random-effects model was used. We evaluated cholecystectomy performed at different periods after percutaneous cholecystostomy within 72 hours or later, within or after one week or percutaneous cholecystostomy, within 10 days or after 10 days, less than 2 weeks or more than 2 weeks, less than 4 weeks or more than 4 weeks, less than 8 weeks or more than 8 weeks as per literature. Results: Six studies including 18640 patients were included in the final analysis. There was no difference in overall complications within or after 72 hours cholecystectomy group, but mortality and biliary complications were significantly high in the less than 72 hours group (p=0.05 and 0.0002 respectively). There was no difference in mortality, overall complication, biliary tract complications in less than 1 week versus more than 1 week and less than 10 days versus more than 10 days group. Overall complications were significantly less in the less than 2 weeks group compared to the more than 2 weeks group. There was no difference in mortality and biliary tract complications between less than 2 weeks and more than 2 weeks group. Overall complication rate (risk ratio 0.67, p <0.0001), postoperative mortality (risk ratio 0.46, p=0.003), bile duct injury (risk ratio 0.62, p=0.01) was significantly less in earlier than 4-week group. Hospital stay was not significantly different between less than 4 weeks versus more than 4 weeks group. (Mean difference= -2.74, p=0.12). Ove all complication rates were significantly more in less than 8 weeks group. (Risk ratio 1.07, p=0.01). Hospital stay was significantly less in less than 8 weeks group. (Mean difference 0.87, p=0.01). Conclusion: Early cholecystectomy preferably within 4 weeks after percutaneous cholecystostomy is preferable over late cholecystectomy.


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