title: Percutaneous cholecystostomy using a central venous catheter is effective for treating high-risk patients with acute cholecystitis.
abstract: Percutaneous cholecystostomy (PC) using a pigtail catheter is performed on high-risk patients with acute cholecystitis as their general condition does not usually allow them to undergo a "definite" cholecystectomy. However, this method of PC is time-consuming and expensive and requires an interventional radiologist and specially designed radiologic equipment. To determine whether another PC approach was viable, we retrospectively compared patients who underwent PC using a central venous catheter (group A, n = 15) with those who underwent standard pigtail catheter PC (group B, n = 29). The waiting time prior to undergoing the PC was 1.8 days in group A and 3.5 days in group B (P < 0.05). The cost per patient was 293,364 won (254.44 dollars) for group A, and 438,719 won (380.50 dollars) for group B (P < 0.05). There were 4 complications in group A and 5 in group B. Following PC, 7 patients in group A and 15 patients in group B underwent delayed definite cholecystectomy, and there were no differences between these groups in terms of complications, mortality, and the delayed definite cholecystectomy surgical method. We conclude that in combination with careful patient selection, PC using a central venous catheter in high-risk patients with acute cholecystitis is a viable alternative to pigtail catheter PC.
authors.affiliation: Department of Surgery, Yonsei University College of Medicine, Seoul, Korea.
authors.forename: Se Ho
authors.initials: SH
authors.lastname: Park
authors.forename: Chang Moo
authors.initials: CM
authors.lastname: Kang
authors.forename: Yoon Seok
authors.initials: YS
authors.lastname: Chae
authors.forename: Kyung Sik
authors.initials: KS
authors.lastname: Kim
authors.forename: Jin Sub
authors.initials: JS
authors.lastname: Choi
authors.forename: Woo Jung
authors.initials: WJ
authors.lastname: Lee
authors.forename: Byong Ro
authors.initials: BR
authors.lastname: Kim
mesh_terms: D000368:Aged; D002405:Catheterization, Central Venous / Q000191:economics; D041881:Cholecystitis, Acute / Q000191:economics / Q000601:surgery*; D002767:Cholecystostomy / Q000191:economics / Q000379:methods*; D004867:Equipment Design; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D018579:Patient Selection; D015641:Radiography, Interventional; D012189:Retrospective Studies