Does percutaneous cholecystostomy affect prognosis of patients with acute cholecystitis that are unresponsive to conservative treatment?
Background: Percutaneous cholecystostomy (PC) can be used as bridging or definitive therapy in some cases of acute cholecystitis. We aimed to compare hospital stay and survival of patients that underwent PC insertion because of acute calculus cholecystitis (ACC) compared to those who did not. Method...
| Main Authors: | , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Wolters Kluwer Medknow Publications
2023-01-01
|
| Series: | The Saudi Journal of Gastroenterology |
| Subjects: | |
| Online Access: | http://www.saudijgastro.com/article.asp?issn=1319-3767;year=2023;volume=29;issue=6;spage=376;epage=380;aulast=Hazan |
| _version_ | 1797226202094632960 |
|---|---|
| author | Danny Hazan Eyal Leibovitz Muhamad Jazmawi Mordechai Shimonov |
| author_facet | Danny Hazan Eyal Leibovitz Muhamad Jazmawi Mordechai Shimonov |
| author_sort | Danny Hazan |
| collection | DOAJ |
| description | Background: Percutaneous cholecystostomy (PC) can be used as bridging or definitive therapy in some cases of acute cholecystitis. We aimed to compare hospital stay and survival of patients that underwent PC insertion because of acute calculus cholecystitis (ACC) compared to those who did not.
Methods: This is a retrospective study in which patients with gangrenous cholecystitis and perforation were excluded. Regression models were used to evaluate the influence of PC on mortality and hospital stay.
Results: Six hundred and eighty-three patients were admitted because of ACC, and 50 patients were referred to PC. Indication for PC insertion were high disease severity index (DSI, 8 pts) and failure of conservative treatment with total disease duration >7 days (42 pts). Those who underwent PC were older (76.0 ± 12.4 vs. 60.8 ± 19.2, P < 0.001); PC was associated with longer hospital stay (12.8 vs. 6.5 days) and higher one-year mortality (20% vs. 4.9%, P < 0.001). Among patients with non-severe disease severity index (DSI), PC was associated with longer length of hospital stay and higher one-year mortality compared to patients treated conservatively (9.9 ± 0.6 vs. 6.0 ± 0.2 days, and 16.7% vs. 4.0%, respectively, P < 0.001 for both). For patients with severe DSI, PC was associated with similar length of hospital stay and one-year mortality compared to similar patients treated conservatively (16.1 ± 8.1 vs. 18.4 ± 4.0 days, and 37.5% vs. 22.6%, respectively, P = 0.802 and P = 0.389, respectively).
Conclusions: In patients with mild–moderate DSI unresponsive to conservative treatment, PC may be associated with deteriorated prognosis compared to conservative treatment. The decision to insert PC in patients unresponsive to conservative therapy even with disease duration >7 days must be re-evaluated. |
| first_indexed | 2024-04-24T14:21:09Z |
| format | Article |
| id | doaj.art-1906b670bad34832bec1b09688ca58fc |
| institution | Directory Open Access Journal |
| issn | 1319-3767 1998-4049 |
| language | English |
| last_indexed | 2024-04-24T14:21:09Z |
| publishDate | 2023-01-01 |
| publisher | Wolters Kluwer Medknow Publications |
| record_format | Article |
| series | The Saudi Journal of Gastroenterology |
| spelling | doaj.art-1906b670bad34832bec1b09688ca58fc2024-04-03T06:40:25ZengWolters Kluwer Medknow PublicationsThe Saudi Journal of Gastroenterology1319-37671998-40492023-01-0129637638010.4103/sjg.sjg_87_23Does percutaneous cholecystostomy affect prognosis of patients with acute cholecystitis that are unresponsive to conservative treatment?Danny HazanEyal LeibovitzMuhamad JazmawiMordechai ShimonovBackground: Percutaneous cholecystostomy (PC) can be used as bridging or definitive therapy in some cases of acute cholecystitis. We aimed to compare hospital stay and survival of patients that underwent PC insertion because of acute calculus cholecystitis (ACC) compared to those who did not. Methods: This is a retrospective study in which patients with gangrenous cholecystitis and perforation were excluded. Regression models were used to evaluate the influence of PC on mortality and hospital stay. Results: Six hundred and eighty-three patients were admitted because of ACC, and 50 patients were referred to PC. Indication for PC insertion were high disease severity index (DSI, 8 pts) and failure of conservative treatment with total disease duration >7 days (42 pts). Those who underwent PC were older (76.0 ± 12.4 vs. 60.8 ± 19.2, P < 0.001); PC was associated with longer hospital stay (12.8 vs. 6.5 days) and higher one-year mortality (20% vs. 4.9%, P < 0.001). Among patients with non-severe disease severity index (DSI), PC was associated with longer length of hospital stay and higher one-year mortality compared to patients treated conservatively (9.9 ± 0.6 vs. 6.0 ± 0.2 days, and 16.7% vs. 4.0%, respectively, P < 0.001 for both). For patients with severe DSI, PC was associated with similar length of hospital stay and one-year mortality compared to similar patients treated conservatively (16.1 ± 8.1 vs. 18.4 ± 4.0 days, and 37.5% vs. 22.6%, respectively, P = 0.802 and P = 0.389, respectively). Conclusions: In patients with mild–moderate DSI unresponsive to conservative treatment, PC may be associated with deteriorated prognosis compared to conservative treatment. The decision to insert PC in patients unresponsive to conservative therapy even with disease duration >7 days must be re-evaluated.http://www.saudijgastro.com/article.asp?issn=1319-3767;year=2023;volume=29;issue=6;spage=376;epage=380;aulast=Hazanacute calculus cholecystitisconservative treatmentpercutaneous cholecystostomy |
| spellingShingle | Danny Hazan Eyal Leibovitz Muhamad Jazmawi Mordechai Shimonov Does percutaneous cholecystostomy affect prognosis of patients with acute cholecystitis that are unresponsive to conservative treatment? The Saudi Journal of Gastroenterology acute calculus cholecystitis conservative treatment percutaneous cholecystostomy |
| title | Does percutaneous cholecystostomy affect prognosis of patients with acute cholecystitis that are unresponsive to conservative treatment? |
| title_full | Does percutaneous cholecystostomy affect prognosis of patients with acute cholecystitis that are unresponsive to conservative treatment? |
| title_fullStr | Does percutaneous cholecystostomy affect prognosis of patients with acute cholecystitis that are unresponsive to conservative treatment? |
| title_full_unstemmed | Does percutaneous cholecystostomy affect prognosis of patients with acute cholecystitis that are unresponsive to conservative treatment? |
| title_short | Does percutaneous cholecystostomy affect prognosis of patients with acute cholecystitis that are unresponsive to conservative treatment? |
| title_sort | does percutaneous cholecystostomy affect prognosis of patients with acute cholecystitis that are unresponsive to conservative treatment |
| topic | acute calculus cholecystitis conservative treatment percutaneous cholecystostomy |
| url | http://www.saudijgastro.com/article.asp?issn=1319-3767;year=2023;volume=29;issue=6;spage=376;epage=380;aulast=Hazan |
| work_keys_str_mv | AT dannyhazan doespercutaneouscholecystostomyaffectprognosisofpatientswithacutecholecystitisthatareunresponsivetoconservativetreatment AT eyalleibovitz doespercutaneouscholecystostomyaffectprognosisofpatientswithacutecholecystitisthatareunresponsivetoconservativetreatment AT muhamadjazmawi doespercutaneouscholecystostomyaffectprognosisofpatientswithacutecholecystitisthatareunresponsivetoconservativetreatment AT mordechaishimonov doespercutaneouscholecystostomyaffectprognosisofpatientswithacutecholecystitisthatareunresponsivetoconservativetreatment |