title: Percutaneous cholecystostomy for acute cholecystitis in critically ill patients.
abstract: BACKGROUND
  Cholecystectomy remains the best treatment for acute cholecystitis but may cause high morbidity or mortality in critically ill or elderly patients.
  
  
  METHODS
  We report a retrospective study of ultrasonography-guided percutaneous cholecystostomy (USGPC) performed between 1988 and 1994 in 41 patients (mean age, 77.8 years; range, 42-95 years) as an alternative to surgery.
  
  
  RESULTS
  Five patients (12.2%) died in the hospital, four (9.8%) subsequently underwent operation without complications, six (15%) had a recurrence of cholecystitis between 3 and 24 months after withdrawal of drainage, and 26 patients are cured without recurrence after a mean follow-up of 33 months (range, 3-67 months).
  
  
  CONCLUSIONS
  USGPC appears to be the treatment of choice for high-risk patients, especially those with postoperative cholecystitis, severe acute calculous pancreatitis, or total parenteral nutrition.
authors.affiliation: Department of Surgery, University Hospital, Nantes, France.
authors.forename: A
authors.initials: A
authors.lastname: Hamy
authors.forename: J
authors.initials: J
authors.lastname: Visset
authors.forename: D
authors.initials: D
authors.lastname: Likholatnikov
authors.forename: F
authors.initials: F
authors.lastname: Lerat
authors.forename: H
authors.initials: H
authors.lastname: Gibaud
authors.forename: B
authors.initials: B
authors.lastname: Savigny
authors.forename: J
authors.initials: J
authors.lastname: Paineau
mesh_terms: D000208:Acute Disease; D000368:Aged; D000369:Aged, 80 and over; D002764:Cholecystitis / Q000150:complications / Q000601:surgery*; D002767:Cholecystostomy / Q000379:methods*; D002769:Cholelithiasis / Q000150:complications; D016638:Critical Illness; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010195:Pancreatitis / Q000150:complications; D012189:Retrospective Studies