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Clinical and operative outcomes of patients with acute cholecystitis who are treated initially with image-guided cholecystostomy

Canadian Journal of Surgery, 2018-06, Vol.61 (3), p.195-199 [Peer Reviewed Journal]

COPYRIGHT 2018 Joule Inc. ;Copyright Joule Inc Jun 2018 ;2018 Joule Inc. or its licensors 2018 ;ISSN: 0008-428X ;EISSN: 1488-2310 ;DOI: 10.1503/cjs.003517 ;PMID: 29806817

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Title:
Clinical and operative outcomes of patients with acute cholecystitis who are treated initially with image-guided cholecystostomy
Author: Molavi, Ida ; Schellenberg, Angela ; Christian, Francis
Subjects: Aged ; Aged, 80 and over ; Bile ; Care and treatment ; Cholecystectomy ; Cholecystectomy - methods ; Cholecystectomy - statistics & numerical data ; Cholecystitis ; Cholecystitis, Acute - surgery ; Cholecystostomy - methods ; Cholecystostomy - statistics & numerical data ; Clinical outcomes ; Comorbidity ; Female ; Gallbladder diseases ; Hospitals ; Humans ; Laparoscopy ; Male ; Medical personnel ; Medical research ; Medical societies ; Medicine, Experimental ; Middle Aged ; Mortality ; Outcome Assessment (Health Care) - statistics & numerical data ; Patient outcomes ; Patients ; Retrospective Studies ; Studies ; Surgery, Computer-Assisted - methods ; Surgery, Computer-Assisted - statistics & numerical data ; Systematic review
Is Part Of: Canadian Journal of Surgery, 2018-06, Vol.61 (3), p.195-199
Description: Percutaneous cholecystostomy (PC) tube placement followed by delayed cholecystectomy has been shown to be an effective treatment option in high-risk populations such as older and critically ill patients. The goal of this study was to review the short- and long-term clinical and operative outcomes of patients with acute cholecystitis initially treated with PC tube placement. We conducted a retrospective review of patients who underwent image-guided PC tube insertion between 2001 and 2011 at the Royal University Hospital or St. Paul's Hospital, Saskatoon. Clinical outcomes, complications and elective cholecystectomy follow-up were noted. A total of 140 patients underwent PC tube insertion, 76 men and 64 women with a mean age of 68.4 (standard deviation 17.7) years. Of the 140, 94 (67.1%) had an American Society of Anesthesiologists classification score of III or IV. Percutaneous cholecystostomy tubes remained in place for a median of 21.0 days, and the median hospital stay was 7.0 days. Readmission owing to complications from PC tubes occurred in 21 patients (15.0%), and 10 (7.1%) were readmitted with recurrent cholecystitis after tube removal. Forty-four patients (31.4%) returned for subsequent elective cholecystectomy, of whom 32 (73%) underwent laparoscopic cholecystectomy, 4 (9%) underwent open cholecystectomy, and 8 (18%) underwent laparoscopic converted to open cholecystectomy. Percutaneous cholecystostomy is a safe procedure that can be performed in patients who are older or have numerous comorbidities. However, less than one-third of such patients in our cohort subsequently had the definitive intervention of elective cholecystectomy, with a high rate of conversion from laparoscopic to open cholecystectomy.
Publisher: Canada: Joule Inc
Language: English;French
Identifier: ISSN: 0008-428X
EISSN: 1488-2310
DOI: 10.1503/cjs.003517
PMID: 29806817
Source: GFMER Free Medical Journals
MEDLINE
PubMed Central
Alma/SFX Local Collection
ProQuest Central

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Clinical and operative outcomes of patients with acute cholecystitis who are treated initially with image-guided cholecystostomy

COPYRIGHT 2018 Joule Inc. ;Copyright Joule Inc Jun 2018 ;2018 Joule Inc. or its licensors 2018 ;ISSN: 0008-428X ;EISSN: 1488-2310 ;DOI: 10.1503/cjs.003517 ;PMID: 29806817

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