Partial cholecystectomy in the emergency treatment of acute cholecystitis in the compromised patient.
Emergency cholecystectomy in the high-risk patient still results in a substantial mortality and morbidity rate. A prospective experience is presented with partial cholecystectomy in 16 high-risk patients (APACHE II greater than 10) undergoing emergency surgery for perforation, empyema or failure to respond to conservative treatment. Excessive bleeding tendency was present in three patients. One patient died (6%). Mean operative time was 40 min. One patient developed an intra-abdominal bile leak due to a retained common bile stone 8 months after operation. Partial cholecystectomy has the advantages of both cholecystectomy and cholecystostomy. It is a fast and safe procedure and should be considered as an option in the emergency situation in the high-risk patient.
Schein
M
M
Department of Surgery, Hillbrow Hospital, Johannesburg, South Africa.
D000208:Acute Disease; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002763:Cholecystectomy / Q000379:methods / Q000401:mortality / Q000592:standards*; D002764:Cholecystitis / Q000453:epidemiology / Q000601:surgery*; D004630:Emergencies; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000453:epidemiology; D011446:Prospective Studies; D012720:Severity of Illness Index; D013019:South Africa / Q000453:epidemiology; D016896:Treatment Outcome