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Percutaneous cholecystostomy in acute cholecystitis; a retrospective analysis of a large series of 104 patients

BACKGROUND: The purpose of this study was to evaluate the clinical course and possible benefit of a percutaneous cholecystostomy in patients with acute cholecystitis. METHODS: Retrospective study of 104 patients with severe cholecystitis or cholecystitis not responding to antibiotic therapy treated...

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Autores principales: Viste, Asgaut, Jensen, Dag, Angelsen, Jon Helge, Hoem, Dag
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BioMed Central 2015
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4357156/
https://www.ncbi.nlm.nih.gov/pubmed/25872885
http://dx.doi.org/10.1186/s12893-015-0002-8
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author Viste, Asgaut
Jensen, Dag
Angelsen, Jon Helge
Hoem, Dag
author_facet Viste, Asgaut
Jensen, Dag
Angelsen, Jon Helge
Hoem, Dag
author_sort Viste, Asgaut
collection PubMed
description BACKGROUND: The purpose of this study was to evaluate the clinical course and possible benefit of a percutaneous cholecystostomy in patients with acute cholecystitis. METHODS: Retrospective study of 104 patients with severe cholecystitis or cholecystitis not responding to antibiotic therapy treated with percutaneous drainage of the gall bladder (PC) during the period 2007 – 2013. Primary outcome was relief of cholecystitis, complications following the procedure and need for later cholecystectomy. RESULTS: There were 57 men and 47 women with a median age of 73,5 years (range 22 – 96). 43% of the patients were ASA III or IV and 91% had cholecystitis Grade 2 or 3. About 60% of the patients had severe comorbidity (cardiovascular disease or active cancer). Drain insertion was successful in all but one patient and complications were mild, apart from two patients that needed percutaneous drainage of intraabdominal fluid collection due to bile leakage. The drain was left in place for 1 – 75 days (median 6,5). When evaluated clinically and by blood tests (CRP and white blood cell counts) we found resolution of symptoms in 101 patients (97,2%), whereas 2 patients had no obvious effect of drainage. Four patients died within 30 days, no deaths were related to the drainage procedure. Follow-up after drainage was median 12 months (range 0 – 78). During that time cholecystectomy was performed in 30 patients and 24 patients had died. Following cholecystectomy, two had died, both from cancer and more than one year after the operation. CONCLUSION: Patients with acute cholecystitis were promptly relieved from their symptoms following PC. There were only minor complications following the procedure and only about 30% of the patients had a later cholecystectomy.
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spelling pubmed-43571562015-03-13 Percutaneous cholecystostomy in acute cholecystitis; a retrospective analysis of a large series of 104 patients Viste, Asgaut Jensen, Dag Angelsen, Jon Helge Hoem, Dag BMC Surg Research Article BACKGROUND: The purpose of this study was to evaluate the clinical course and possible benefit of a percutaneous cholecystostomy in patients with acute cholecystitis. METHODS: Retrospective study of 104 patients with severe cholecystitis or cholecystitis not responding to antibiotic therapy treated with percutaneous drainage of the gall bladder (PC) during the period 2007 – 2013. Primary outcome was relief of cholecystitis, complications following the procedure and need for later cholecystectomy. RESULTS: There were 57 men and 47 women with a median age of 73,5 years (range 22 – 96). 43% of the patients were ASA III or IV and 91% had cholecystitis Grade 2 or 3. About 60% of the patients had severe comorbidity (cardiovascular disease or active cancer). Drain insertion was successful in all but one patient and complications were mild, apart from two patients that needed percutaneous drainage of intraabdominal fluid collection due to bile leakage. The drain was left in place for 1 – 75 days (median 6,5). When evaluated clinically and by blood tests (CRP and white blood cell counts) we found resolution of symptoms in 101 patients (97,2%), whereas 2 patients had no obvious effect of drainage. Four patients died within 30 days, no deaths were related to the drainage procedure. Follow-up after drainage was median 12 months (range 0 – 78). During that time cholecystectomy was performed in 30 patients and 24 patients had died. Following cholecystectomy, two had died, both from cancer and more than one year after the operation. CONCLUSION: Patients with acute cholecystitis were promptly relieved from their symptoms following PC. There were only minor complications following the procedure and only about 30% of the patients had a later cholecystectomy. BioMed Central 2015-03-08 /pmc/articles/PMC4357156/ /pubmed/25872885 http://dx.doi.org/10.1186/s12893-015-0002-8 Text en © Viste et al.; licensee BioMed Central. 2015 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly credited. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.
spellingShingle Research Article
Viste, Asgaut
Jensen, Dag
Angelsen, Jon Helge
Hoem, Dag
Percutaneous cholecystostomy in acute cholecystitis; a retrospective analysis of a large series of 104 patients
title Percutaneous cholecystostomy in acute cholecystitis; a retrospective analysis of a large series of 104 patients
title_full Percutaneous cholecystostomy in acute cholecystitis; a retrospective analysis of a large series of 104 patients
title_fullStr Percutaneous cholecystostomy in acute cholecystitis; a retrospective analysis of a large series of 104 patients
title_full_unstemmed Percutaneous cholecystostomy in acute cholecystitis; a retrospective analysis of a large series of 104 patients
title_short Percutaneous cholecystostomy in acute cholecystitis; a retrospective analysis of a large series of 104 patients
title_sort percutaneous cholecystostomy in acute cholecystitis; a retrospective analysis of a large series of 104 patients
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4357156/
https://www.ncbi.nlm.nih.gov/pubmed/25872885
http://dx.doi.org/10.1186/s12893-015-0002-8
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