title: Early Percutaneous Cholecystostomy in Severe Acute Cholecystitis Reduces the Complication Rate and Duration of Hospital Stay.
abstract: The optimal timing of percutaneous cholecystostomy for severe acute cholecystitis is unclear. The aim of this study was to investigate the timing of percutaneous cholecystostomy and its relationship to clinical outcomes in patients with inoperable acute severe cholecystitis.From 2008 to 2010, 209 consecutive patients who were admitted to our hospital due to acute cholecystitis and were treated by percutaneous cholecystostomy were retrospectively reviewed. The time periods from symptom onset to when percutaneous cholecystostomy was performed and when patients were discharged were recorded.In the 209 patients, the median time period between symptom onset and percutaneous cholecystostomy was 23 hours (range, 3-95 hours). The early intervention group (≤24 hours, n = 109) had a significantly lower procedure-related bleeding rate (0.0% vs 5.0%, P = 0.018) and shorter hospital stay (15.8 ± 12.9 vs 21.0 ± 17.5 days) as compared with the late intervention group (>24 hours, n = 100). Delayed percutaneous cholecystostomy was a significant independent factor for a longer hospital stay (odds ratio 3.03, P = 0.001).In inoperable patients with acute severe cholecystitis, early percutaneous cholecystostomy reduced hospital stay and procedure-related bleeding without increasing the mortality rate.
authors.affiliation: From the Division of Gastroenterology, Department of Medicine, Taipei Veterans General Hospital, Taipei (CK Chou, KCL, CCC, CLP, HCL); Department of Medicine, National Yang-Ming University School of Medicine (CK Chou, KCL, CCC, CLP, HCL); Division of Gastroenterol- ogy, Department of Medicine, National Yang-Ming University Hospital, Ilan (CK Chou); Department of Radiology, Taipei Veterans General Hospital (CK Chen); and Division of General Surgery, Department of Surgery, Taipei Veterans General Hospital, Taipei, Taiwan (WLF).
authors.forename: Chung-Kai
authors.initials: CK
authors.lastname: Chou
authors.forename: Kuei-Chuan
authors.initials: KC
authors.lastname: Lee
authors.forename: Che-Chang
authors.initials: CC
authors.lastname: Chan
authors.forename: Chin-Lin
authors.initials: CL
authors.lastname: Perng
authors.forename: Chun-Ku
authors.initials: CK
authors.lastname: Chen
authors.forename: Wen-Liang
authors.initials: WL
authors.lastname: Fang
authors.forename: Han-Chieh
authors.initials: HC
authors.lastname: Lin
mesh_terms: D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D041881:Cholecystitis, Acute / Q000601:surgery*; D002767:Cholecystostomy / Q000009:adverse effects* / Q000379:methods* / Q000401:mortality; D005260:Female; D017052:Hospital Mortality; D006801:Humans; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D019060:Minimally Invasive Surgical Procedures / Q000009:adverse effects* / Q000379:methods* / Q000401:mortality; D011183:Postoperative Complications / Q000453:epidemiology*; D012189:Retrospective Studies; D012737:Sex Factors; D013997:Time Factors