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Percutaneous cholecystostomy in patients with acute cholecystitis: experience of 45 patients at a US referral center.

Publication ,  Journal Article
Byrne, MF; Suhocki, P; Mitchell, RM; Pappas, TN; Stiffler, HL; Jowell, PS; Branch, MS; Baillie, J
Published in: J Am Coll Surg
August 2003

BACKGROUND: Standard treatment for acute cholecystitis is cholecystectomy, but some patients are at high risk for immediate surgery. Percutaneous cholecystostomy might be the procedure of choice in this group. We reviewed the experience of percutaneous cholecystostomy in a large tertiary center population. STUDY DESIGN: We performed a retrospective analysis of patients who underwent percutaneous cholecystostomy, and recorded indications for cholecystostomy, duration of tube placement, clinical outcome, death within 30 days of procedure, complications, bacteriology of aspirated bile, gallbladder contents, and performance of interval cholecystectomy. RESULTS: Forty-five patients (mean age 63 years) had cholecystostomy tubes placed from July 1999 to March 2002. All had confirmed or presumed acute cholecystitis. Mean duration of tube insertion was 54.3 days. Thirty-six patients improved clinically within 5 days. Nine patients died within 30 days; only one death was directly related to gallbladder sepsis. Nine patients subsequently had laparoscopic cholecystectomy, eight had open cholecystectomy, and two had cholecystoenterostomy. Cholecystectomy was planned in another five patients. Cholecystostomy tubes leaked in two patients, blocked in four, and dislodged in one. One patient developed a hemoperitoneum. Bile aspirated at cholecystostomy was culture positive in 12 patients, negative in 16, and not sent or recorded in 17. Twenty-two patients had gallstones, 10 had sludge, 9 had both, and 4 had neither. CONCLUSIONS: In experienced hands, percutaneous cholecystostomy is easy to perform, with low complication and high success rates. It is the procedure of choice in patients with acute cholecystitis unfit for emergency surgery. Patients often improve clinically, so that cholecystectomy can be done electively.

Duke Scholars

Published In

J Am Coll Surg

DOI

ISSN

1072-7515

Publication Date

August 2003

Volume

197

Issue

2

Start / End Page

206 / 211

Location

United States

Related Subject Headings

  • Surgery
  • Retrospective Studies
  • Reoperation
  • Middle Aged
  • Humans
  • Cholecystostomy
  • Cholecystitis
  • Cholecystectomy
  • Child, Preschool
  • Child
 

Citation

APA
Chicago
ICMJE
MLA
NLM
Byrne, M. F., Suhocki, P., Mitchell, R. M., Pappas, T. N., Stiffler, H. L., Jowell, P. S., … Baillie, J. (2003). Percutaneous cholecystostomy in patients with acute cholecystitis: experience of 45 patients at a US referral center. J Am Coll Surg, 197(2), 206–211. https://doi.org/10.1016/S1072-7515(03)00143-1
Byrne, Michael F., Paul Suhocki, Robert M. Mitchell, Theodore N. Pappas, Helen L. Stiffler, Paul S. Jowell, Malcolm S. Branch, and John Baillie. “Percutaneous cholecystostomy in patients with acute cholecystitis: experience of 45 patients at a US referral center.J Am Coll Surg 197, no. 2 (August 2003): 206–11. https://doi.org/10.1016/S1072-7515(03)00143-1.
Byrne MF, Suhocki P, Mitchell RM, Pappas TN, Stiffler HL, Jowell PS, et al. Percutaneous cholecystostomy in patients with acute cholecystitis: experience of 45 patients at a US referral center. J Am Coll Surg. 2003 Aug;197(2):206–11.
Byrne, Michael F., et al. “Percutaneous cholecystostomy in patients with acute cholecystitis: experience of 45 patients at a US referral center.J Am Coll Surg, vol. 197, no. 2, Aug. 2003, pp. 206–11. Pubmed, doi:10.1016/S1072-7515(03)00143-1.
Byrne MF, Suhocki P, Mitchell RM, Pappas TN, Stiffler HL, Jowell PS, Branch MS, Baillie J. Percutaneous cholecystostomy in patients with acute cholecystitis: experience of 45 patients at a US referral center. J Am Coll Surg. 2003 Aug;197(2):206–211.
Journal cover image

Published In

J Am Coll Surg

DOI

ISSN

1072-7515

Publication Date

August 2003

Volume

197

Issue

2

Start / End Page

206 / 211

Location

United States

Related Subject Headings

  • Surgery
  • Retrospective Studies
  • Reoperation
  • Middle Aged
  • Humans
  • Cholecystostomy
  • Cholecystitis
  • Cholecystectomy
  • Child, Preschool
  • Child