Purpose
The aim of this study was:
To assess the clinical course and possible benefit of US-guided percutaneous cholecystostomy (PC) in high risk patients with acute cholecystitis.
Methods and materials
All patients with acute cholecystitis who underwent US-guided percutaneous cholecystostomy (PC) between 2013 and 2018 in a single center were retrospectively reviewed.
Detailed information was collected on:
comorbidities (cardiovascular, neurological, respiratory and renal dysfunction);
clinical symptoms;
laboratory values (WBC, CRP);
prior-PC imaging.
The imaging studies performed prior-PC included Ultra-Sound (US) and Computed Tomography (CT).Concerning prior-PC imaging, the following findings were recorded: one or more gallstone(s), distended gallbladder, edematous gallbladder, ruptured gallbladder, pericholecystic fluid, positive US Murphy's sign.
Laboratory values (WBC; CRP) were retrospectively collected through...
Results
A total of 80 (23% female; age [±SD] 78 [±1.5years]) moderate and high risk (TG18 grade II-III) patients who underwent a PC were included.
PC procedure was technically successful in 100% 80/80 patients.
No major complications were recorded.
In total 13/80 16% of patients deceased. Of these 2 (15%) underwent urgent CH.
All the PC were performed under US-guidance and a pig tail catheter (8-10F) was inserted through the liver parenchyma using transhepatic approach [4].Figure 3shows correctcatheter insertion in the gallbladder using Seldinger technique andtranshepatic...
Conclusion
PC is a minimally invasive and successful procedure in high risk patients with acute cholecystitis. PC led to a complete resolution of acute symptoms and/or was a bridge for surgery.
Personal information and conflict of interest
S. Schiro'; Parma/IT - nothing to disclose A. Andreone; Parma/IT - nothing to disclose I. Paladini; Parma/IT - nothing to disclose E. Epifani; Parma/IT - nothing to disclose C. Marcato; Parma, ITALY/IT - nothing to disclose N. Sverzellati; Parma/IT - nothing to disclose
References
1.Viste A, Jensen D, Angelsen JH, Hoem D. Percutaneous cholecystostomy in acute cholecystitis; a retrospective analysis of a large series of 104 patients. BMC Surg. 2015;15:17.
2. Yokoe M, Takada T, Strasberg SM, Solomkin JS, Mayumi T, Gomi H, et al. New diagnostic criteria and severity assessment of acute cholecystitis in revised Tokyo Guidelines. J Hepatobil- iary Pancreat Sci. 2012;19:578–85.
3.Miura F, Okamoto K, Takada T, Strasberg SM, Asbun HJ, Pitt HA, et al. Tokyo Guidelines 2018: initial management of acute biliary infection and flowchart...
