title: Interval percutaneous cholecystostomy is effective for decompression of the common bile duct in high-risk elderly patients prior to endoscopic retrograde cholangiopancreatography.
abstract: BACKGROUND
  Endoscopic retrograde cholangiopancreatography (ERCP) is the preferred procedure for common bile duct decompression. Nevertheless, this procedure may be hazardous for high-risk elderly patients.
  
  
  OBJECTIVE
  To assess retrospectively whether interval percutaneous cholecystostomy (PC) should be considered in high-risk patients until their condition has improved and allows ERCP to be performed.
  
  
  METHODS
  Referral community teaching hospital.
  
  
  METHODS
  8 elderly high-risk patients with acute cholangitis.
  
  
  METHODS
  All underwent PC as a bridging procedure till performing ERCP.
  
  
  RESULTS
  Age ranged from 72 to 91 years (median 87). All 8 patients underwent PC. PC insertion improved their general condition and allowed us to perform an ERCP later on. Median time between PC and ERCP was 5 days. In 3 patients there was no need to perform an ERCP. All were discharged in a generally good condition and after normalization of bilirubin and liver enzymes. Median length of stay in hospital was 18 days.
  
  
  CONCLUSIONS
  PC, as a bridging procedure to ERCP, can be an appropriate approach for selective high-risk elderly patients in whom ERCP is considered to be difficult and hazardous at the time of presentation.
authors.affiliation: Department of Gastroenterology, Shaare-Zedek Medical Center, Jerusalem, Israel. davariel@zahav.net.il
authors.forename: Ariella Bar-Gil
authors.initials: AB
authors.lastname: Shitrit
authors.forename: Dan
authors.initials: D
authors.lastname: Braverman
mesh_terms: D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D002760:Cholangiopancreatography, Endoscopic Retrograde; D002761:Cholangitis / Q000209:etiology / Q000601:surgery*; D002767:Cholecystostomy / Q000379:methods*; D015331:Cohort Studies; D003137:Common Bile Duct Diseases / Q000209:etiology / Q000601:surgery*; D019299:Decompression, Surgical / Q000379:methods*; D005260:Female; D006801:Humans; D007902:Length of Stay; D008297:Male; D012189:Retrospective Studies; D016896:Treatment Outcome