Percutaneous cholecystostomy for acute cholecystitis in veteran patients.
BACKGROUND
Surgical cholecystostomy has been shown to carry a significantly higher mortality rate at Veterans Administration (VA) hospitals than at non-federal hospitals in the past.


METHODS
A retrospective outcomes study was undertaken at a large VA medical center with a policy favoring radiologic over surgical cholecystostomy over the past 9 years. Records of 24 consecutive patients with acute cholecystitis were reviewed to evaluate the effectiveness of the procedure.


RESULTS
Cholecystostomy was performed radiologically in 22 patients and surgically in 2 patients. Most (78%) of patients improved within 48 hours. The periprocedural mortality was 25%. The majority of these patients died from unrelated illnesses. Four patients developed complications, none of which required operative intervention.


CONCLUSIONS
Comorbidities are the most important mortality factor for cholecystostomies in VA patients. Radiologic tube placement is effective and uncomplicated in most cases.
Chang
L
L
Surgical Service, Veterans Administration Puget Sound Health Care System, Department of Surgery, University of Washington, Seattle, Washington 98108, USA.
Moonka
R
R
Stelzner
M
M
D000208:Acute Disease; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002764:Cholecystitis / Q000401:mortality* / Q000601:surgery*; D002767:Cholecystostomy / Q000379:methods* / Q000706:statistics & numerical data; D005260:Female; D006801:Humans; D008297:Male; D008499:Medical Records; D008875:Middle Aged; D012189:Retrospective Studies; D015607:Stents; D016019:Survival Analysis; D016896:Treatment Outcome; D014728:Veterans / Q000706:statistics & numerical data*; D014861:Washington / Q000453:epidemiology