Timing of Cholecystectomy after Percutaneous Cholecystostomy for Acute Cholecystitis.
OBJECTIVE
Laparoscopic cholecystectomy is the standard treatment for acute cholecystitis. Percutaneous cholecystostomy is an alternative treatment to resolve acute inflammation in patients with severe comorbidities. The purpose of this study is to determine the optimal timing of laparoscopic cholecystectomy after percutaneous cholecystostomy for the patients with acute cholecystitis.


METHODS
This retrospective study was conducted in patients who underwent cholecystectomy after percutaneous cholecystostomy from January 2010 through November 2014. Seventy-four patients were included in this study. The patients were divided into two groups by the operation timing. Group I patients underwent cholecystectomy within 10 days after percutaneous cholecystostomy (n=30) and group II patients underwent cholecystectomy at more than 10 days after percutaneous cholecystostomy (n=44).


RESULTS
There was no significant difference between groups in conversion rate to open surgery, operation time, perioperative complications rate, and days of hospital stay after operation. However, complications related to cholecystostomy such as catheter dislodgement occurred significantly more often in group II than group I (group I:group II=0%:18.2%; p=0.013).


CONCLUSIONS
Timing of laparoscopic cholecystectomy after percutaneous cholecystostomy did not influence postoperative outcomes. However, late surgery caused more complications related to cholecystostomy than early surgery. Therefore, early laparoscopic cholecystectomy should be considered over late surgery after percutaneous cholecystostomy insertion.
Department of Surgery, Wonkwang University School of Medicine, Iksan, Korea.
Woo Hyun
WH
Jung
Department of Surgery, Wonkwang University School of Medicine, Iksan, Korea.
Dong Eun
DE
Park
D000368:Aged; D000369:Aged, 80 and over; D017081:Cholecystectomy, Laparoscopic / Q000009:adverse effects; D041881:Cholecystitis, Acute / Q000175:diagnosis* / Q000601:surgery; D002767:Cholecystostomy; D005260:Female; D006801:Humans; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications; D012189:Retrospective Studies
Acute cholecystitis; Cholecystostomy; Laparoscopic cholecystectomy