Safety and Usefulness of Percutaneous Transhepatic Cholecystoscopy (PTCCS) in High-Risk Surgical Patients Manifesting Acute Cholecystitis.
- Author:
Chi Sook YOO
1
;
Hong Ja KIM
;
Ha Young KIM
;
Kyung A LEE
;
Sung Hee CHUNG
;
Saera JUNG
;
Hee Gon SONG
;
Yeon Ho JOO
;
Dong Wan SEO
;
Sung Koo LEE
;
Myung Hwan KIM
;
Young Il MIN
Author Information
1. Department of Internal Medicine, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Korea. mhkim@www.amc.seoul.kr
- Publication Type:Original Article
- Keywords:
Percutaneous transhepatic cholecystoscopy (PTCCS);
Acute cholecystitis;
High surgical risk patient
- MeSH:
Bile;
Cholecystitis, Acute*;
Cholecystostomy;
Clonorchiasis;
Follow-Up Studies;
Gallbladder;
Gallbladder Neoplasms;
Gallstones;
Hemorrhage;
Humans;
Lithotripsy;
Sewage
- From:Korean Journal of Gastrointestinal Endoscopy
2001;22(1):27-31
- CountryRepublic of Korea
- Language:Korean
-
Abstract:
BACKGROUND/AIMS: The aim of the present study is to identify the diagnostic and therapeutic usefulness of percutaneous transhepatic cholecystoscopic examination (PTCCS) in high-risk surgical patients manifesting acute cholecystitis. METHODS: Between January 1992 and June 1998, 33 consecutive patients who underwent percutaneous transhepatic cholecystostomy (PC) and subsequent PTCCS for the management of acute cholecystitis were included. RESULTS: PC and subsequent PTCCS were successfully accomplished in all of 33 patients. During PTCCS, minor complication (2 of minor bleeding during electrohydraulic lithotripsy, 2 of tube dislodgement and 1 of bile leakage to peritoneum) occurred in five patients. PTCCS revealed 26 cases of gallstones, 3 cases of sludge ball, 3 cases of gallbladder carcinoma and 1 case of clonorchiasis related with acute cholecystitis. Three cases of the gallbladder cancers which were not predicted radiologically were incidentally found during PTCCS. For 26 patients with gallstones, PTCCS and concomitant stone removal were successfully carried out in one to four consecutive sessions (mean 2.2 sessions). Gallstones recurred in three (3/22, 14%) patients during the mean follow-up period of 27 months. All of them remain asymptomatic. CONCLUSIONS: PTCCS may be justified in the management of acute cholecystitis in selected patients with high surgical risk.
