title: Technique and indications of percutaneous cholecystostomy in the management of cholecystitis in 2014.
abstract: The gold standard in treatment of acute cholecystitis is cholecystectomy associated with antibiotics. In certain circumstances, percutaneous cholecystostomy is an interventional alternative. Percutaneous cholecystostomy is usually performed under local anesthesia by the radiologist using ultrasonographic or CT guidance. A drain can be inserted either through a trans-hepatic or a trans-peritoneal approach. Complications occur in nearly 10% of cases including hemorrhage, hemobilia, pneumothorax or bile leaks, depending on whether the approach was trans-hepatic or trans-peritoneal. The main indications for percutaneous cholecystostomy are resistance to medical treatment or severely-ill patients in intensive care. Drains should be maintained 3 to 6 weeks before removal. In patients with good general condition (ASA score I-II), secondary cholecystectomy can be recommended to avoid recurrence.
authors.affiliation: Service de chirurgie digestive et endocrinienne, CHU, 4, rue Larrey, 49933 Angers cedex, France.
authors.forename: A
authors.initials: A
authors.lastname: Venara
authors.affiliation: Service de radiologie, CHU, 4, rue Larrey, 49933 Angers cedex, France.
authors.forename: V
authors.initials: V
authors.lastname: Carretier
authors.affiliation: Service de radiologie, CHU, 4, rue Larrey, 49933 Angers cedex, France.
authors.forename: J
authors.initials: J
authors.lastname: Lebigot
authors.affiliation: Service de chirurgie digestive et endocrinienne, CHU, 4, rue Larrey, 49933 Angers cedex, France. Electronic address: emlermite@chu-angers.fr.
authors.forename: E
authors.initials: E
authors.lastname: Lermite
mesh_terms: D041881:Cholecystitis, Acute / Q000000981:diagnostic imaging / Q000601:surgery*; D002767:Cholecystostomy / Q000379:methods*; D000075202:Contraindications; D006801:Humans; D015641:Radiography, Interventional; D014057:Tomography, X-Ray Computed; D018084:Ultrasonography, Interventional
keywords: Cholecystitis; Cholecystostomy; Interventional radiology; Non-surgical management