Percutaneous Cholecystostomy at the Community Hospital: Value Evaluation.
10.3348/jkrs.1997.37.4.635
- Author:
Jeong Min LEE
1
;
Mi Suk LEE
;
Jin Hee LEE
;
Seong Hee YM
;
Young Gun YOON
;
Myung Hee SOHN
;
Chong Soo KIM
;
Young Min HAN
;
Ki Chul CHOI
Author Information
1. Department of Diagnostic Radiology, Namwon Medical Center,
- Publication Type:Original Article
- Keywords:
Gallbladder, interventional procedure;
Cholecystitis
- MeSH:
Abdominal Pain;
Acalculous Cholecystitis;
Bile;
Catheters;
Cholangitis;
Cholecystectomy;
Cholecystitis;
Cholecystitis, Acute;
Cholecystostomy*;
Critical Illness;
Diabetes Mellitus;
Emergencies;
Gallbladder;
Heart Diseases;
Hospitals, Community*;
Humans;
Liver Cirrhosis;
Peritonitis;
Risk Factors;
Ultrasonography
- From:Journal of the Korean Radiological Society
1997;37(4):635-640
- CountryRepublic of Korea
- Language:English
-
Abstract:
PURPOSE: To assess the role of percutaneous cholecystostomy as a therapeutic maneuver in patients critically ill with acute cholecystitis in community hospitals. MATERIALS AND METHODS: Eighteen patients, 11 with suspected acute calculous cholecystits and seven with acute acalculous cholecystitis underwent emergency percutaneous cholecystostomy. All demonstrated a variety of high risk factors for cholecystectomy: liver cirrhosis (n=2), diabetes mellitus (n=3), cardiac disease (n=3), underlying malignancy (n=2), pulmonary dysfunction (n=1), septic cholangitis (n=5), and old age (n=2). All percutaneous cholecystostomies were performed with ultrasound guidance and preferably using the transhepatic route. RESULTS: All procedures but one were successful, and most cholecystostomies were performed within 5-20 minutes. Technical problems were as follows: guide-wire buckling during catheter insertion (n=2) and procedure failure (n=1). The only major problem was a case of localized bile peritonitis due to procedural failure, but a few minor complications were encountered: catheter dislodgment (n=3), and significant abdominal pain during the procedure (2). After successful cholecystostomy, a dramatic improvement in clinical condition was observed in 16 of 17 patients (94%) within 48 hours. Ten of 16 patients who responded to percutaneous cholecystostomy underwent elective cholecystectomy after the improvement of clinical symptoms, and the remaining six patients improved without other gallbladder interventions. CONCLUSION: Percutaneous cholecystostomy is not only an effective procedure for acute cholecystitis, but also has a definite role in the management of these high-risk patients in community hospitals.
