Ultrasound-guided percutaneous cholecystostomy for acute cholecystitis in critically ill patients: one center's experience.
OBJECTIVE
The standard treatment for acute cholecystitis is cholecystectomy; however, cholecystectomy is not an option in some patients who are too high-risk for emergency surgery. Ultrasound-guided percutaneous cholecystostomy is an alternative for such patients. This study presents one center's five-year clinical experience with ultrasound-guided percutaneous cholecystostomy for treatment of acute cholecystitis.


METHODS
In this study the records of all patients (18 total; mean age, 68.2+/-15.4 years; range, 42-91 years) who underwent ultrasound-guided percutaneous cholecystostomy for acute cholecystitis between June 1998 and October 2003 were reviewed. Duration of hospitalization, duration of tube placement, mortality and morbidity after tube placement, complication rates, culture results for aspirated bile, and clinical outcomes were analyzed.


RESULTS
Fourteen patients were diagnosed with acute calculous cholecystitis and four were diagnosed with acalculous cholecystitis. The average hospital stay was 19+/-12.6 days (range, 5-52 days), and the average duration of catheter drainage was 20.5+/-19.1 days (range, 1-75 days). Six patients underwent open cholecystectomy between days 16 and 26 of catheter drainage, and none had postoperative complications.


CONCLUSIONS
Ultrasound-guided percutaneous cholecystostomy is a relatively safe and easy method for treating acute cholecystitis in critically ill patients. The risk of complications is low and the likelihood of success is high.
Başaran
Ozgür
O
Department of General Surgery, Faculty of Medicine, Başkent University, Ankara, Turkey. ozgurb@baskent-ank.edu.tr
Yavuzer
Nazli
N
Selçuk
Haldun
H
Harman
Ali
A
Karakayali
Hamdi
H
Bilgin
Nevzat
N
D042101:Acalculous Cholecystitis / Q000000981:diagnostic imaging / Q000601:surgery; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D002404:Catheterization; D041881:Cholecystitis, Acute / Q000000981:diagnostic imaging* / Q000473:pathology / Q000601:surgery*; D002765:Cholecystography; D002767:Cholecystostomy / Q000009:adverse effects / Q000295:instrumentation / Q000379:methods; D016638:Critical Illness; D004322:Drainage / Q000295:instrumentation; D005260:Female; D006801:Humans; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D016019:Survival Analysis; D016896:Treatment Outcome; D014421:Turkey; D018084:Ultrasonography, Interventional
D000900:Anti-Bacterial Agents