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Percutaneous Cholecystostomy for Patients with Acute Cholecystitis and an Increased Surgical Risk

Journal Article · · Cardiovascular and Interventional Radiology
DOI:https://doi.org/10.1007/S002709900017· OSTI ID:21080553
;  [1]; ;  [2];  [1]
  1. Department of Radiology, University Hospital Dijkzigt, Dr. Molewaterplein 40, NL-3015 GD Rotterdam (Netherlands)
  2. Department of Surgery, University Hospital Dijkzigt, Dr. Molewaterplein 40, NL-3015 Rotterdam (Netherlands)

Purpose: To evaluate percutaneous cholecystostomy in patients with acute cholecystitis and an increased surgical risk. Methods: Thirty-three patients with acute cholecystitis (calculous, n= 22; acalculous, n= 11) underwent percutaneous cholecystostomy by means of a transhepatic (n= 21) or transperitoneal (n= 12) access route. Clinical and laboratory parameters were retrospectively studied to determine the benefit from cholecystostomy. Results: All procedures were technically successful. Twenty-two (67%) patients improved clinically within 48 hr; showing a significant decrease in body temperature (n= 13), normalization of the white blood cell count (n= 3), or both (n= 6). There were 6 (18%) minor/moderate complications (transhepatic access, n= 3; transperitoneal access, n= 3). Further treatment for patients with calculous cholecystitis was cholecystectomy (n= 9) and percutaneous and endoscopic stone removal (n= 8). Further treatment for patients with acalculous cholecystitis was cholecystectomy (n= 2) and gallbladder ablation (n= 2). There were 4 deaths (12%) either in hospital or within 30 days of drainage; none of the deaths was procedure-related. Conclusions: Percutaneous cholecystostomy is a safe and effective procedure for patients with acute cholecystitis. For most patients with acalculous cholecystitis percutaneous cholecystostomy may be considered a definitive therapy. In calculous disease this treatment is often only temporizing and a definitive surgical, endoscopic, or radiologic treatment becomes necessary.

OSTI ID:
21080553
Journal Information:
Cardiovascular and Interventional Radiology, Journal Name: Cardiovascular and Interventional Radiology Journal Issue: 2 Vol. 19; ISSN 0174-1551; ISSN CAIRDG
Country of Publication:
United States
Language:
English

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