Percutaneous cholecystostomy: single centre experience in 111 patients with an acute cholecystitis

'Purpose: 'To evaluate the safety and long-term outcome of percutaneous cholecystostomy (PC) under radiologic guidance for acute calculous cholecystitis (ACC) and acute acalculous cholecystitis (AAC) in all patients undergoing that procedure at our institution. 'Materials and methods:...

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Main Authors: R Peters, S Kolderman, B Peters, M Simoens, S Braak
Format: Article
Language:English
Published: Ubiquity Press 2014-07-01
Series:Journal of the Belgian Society of Radiology
Subjects:
Online Access:https://www.jbsr.be/articles/101
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author R Peters
S Kolderman
B Peters
M Simoens
S Braak
author_facet R Peters
S Kolderman
B Peters
M Simoens
S Braak
author_sort R Peters
collection DOAJ
description 'Purpose: 'To evaluate the safety and long-term outcome of percutaneous cholecystostomy (PC) under radiologic guidance for acute calculous cholecystitis (ACC) and acute acalculous cholecystitis (AAC) in all patients undergoing that procedure at our institution. 'Materials and methods: 'We performed a retrospective analysis of 111 patients who underwent PC from 2004 to 2012. Patients were divided into two groups: AAC and ACC. For all patients, comorbidity and American Society of Anesthesiologists (ASA) classification were determined. The indications, complications, recurrence rate and long-term outcome for both groups were analysed. The mean follow-up was 55 months. 'Results: 'Twenty-four patients with AAC and 87 patients with ACC underwent PC. The most common sonographic findings of ACC and AAC were gallbladder wall thickening (90,9%) and hydrops (72,9%). Twelve of 24 patients with AAC (50%) were hospitalized at the Intensive Care Unit (ICU). Overall, the procedure failed in 2 (1,8%) patients. There were 4 (3,6%) abscesses and 2 (1,8%) fistulas post PC. Drain dislodgment was found without sequelae in 8 (7,2%) patients. Elective cholecystectomy was performed in 35/111 (31,5%). Fifty-one of 87 (58,6%) patients with gallstones underwent cholecystectomy; 36/87 (41,3%) did not undergo surgery due to a too short follow-up or death of nonbiliary disease. In the AAC group, there was no recurrent cholecystitis in 17/24 (70,8%) patients; 3/24 (12,5%) underwent surgery and 4/24 (16,6%) patients died in the ICU. 'Conclusion: 'PC is a minimally invasive treatment with low complication rate for patients with acute cholecystitis whom considered being at high-risk for urgent cholecystectomy. Good selection (ASA III and IV) and indication is needed in patients with ACC before PC because the majority will be operated later on. AAC can be managed nonoperatively and further treatment might not be needed.
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spelling doaj.art-2f7fa04c81f744699b38cec76987fe6b2022-12-22T02:17:56ZengUbiquity PressJournal of the Belgian Society of Radiology2514-82812014-07-0197419720110.5334/jbr-btr.101101Percutaneous cholecystostomy: single centre experience in 111 patients with an acute cholecystitisR Peters0S Kolderman1B Peters2M Simoens3S Braak4Department of Radiology, ZGT, Almelo, The NetherlandsDepartment of Radiology, UMCG, Groningen, The NetherlandsDepartment of Internal Medicine, AZ Monica, Antwerpen, BelgiumDepartment of Surgery, ZGT Almelo, The NetherlandsDepartment of Radiology, ZGT, Almelo, The Netherlands'Purpose: 'To evaluate the safety and long-term outcome of percutaneous cholecystostomy (PC) under radiologic guidance for acute calculous cholecystitis (ACC) and acute acalculous cholecystitis (AAC) in all patients undergoing that procedure at our institution. 'Materials and methods: 'We performed a retrospective analysis of 111 patients who underwent PC from 2004 to 2012. Patients were divided into two groups: AAC and ACC. For all patients, comorbidity and American Society of Anesthesiologists (ASA) classification were determined. The indications, complications, recurrence rate and long-term outcome for both groups were analysed. The mean follow-up was 55 months. 'Results: 'Twenty-four patients with AAC and 87 patients with ACC underwent PC. The most common sonographic findings of ACC and AAC were gallbladder wall thickening (90,9%) and hydrops (72,9%). Twelve of 24 patients with AAC (50%) were hospitalized at the Intensive Care Unit (ICU). Overall, the procedure failed in 2 (1,8%) patients. There were 4 (3,6%) abscesses and 2 (1,8%) fistulas post PC. Drain dislodgment was found without sequelae in 8 (7,2%) patients. Elective cholecystectomy was performed in 35/111 (31,5%). Fifty-one of 87 (58,6%) patients with gallstones underwent cholecystectomy; 36/87 (41,3%) did not undergo surgery due to a too short follow-up or death of nonbiliary disease. In the AAC group, there was no recurrent cholecystitis in 17/24 (70,8%) patients; 3/24 (12,5%) underwent surgery and 4/24 (16,6%) patients died in the ICU. 'Conclusion: 'PC is a minimally invasive treatment with low complication rate for patients with acute cholecystitis whom considered being at high-risk for urgent cholecystectomy. Good selection (ASA III and IV) and indication is needed in patients with ACC before PC because the majority will be operated later on. AAC can be managed nonoperatively and further treatment might not be needed.https://www.jbsr.be/articles/101Gallbladderinterventional procedure – Cholecystitis
spellingShingle R Peters
S Kolderman
B Peters
M Simoens
S Braak
Percutaneous cholecystostomy: single centre experience in 111 patients with an acute cholecystitis
Journal of the Belgian Society of Radiology
Gallbladder
interventional procedure – Cholecystitis
title Percutaneous cholecystostomy: single centre experience in 111 patients with an acute cholecystitis
title_full Percutaneous cholecystostomy: single centre experience in 111 patients with an acute cholecystitis
title_fullStr Percutaneous cholecystostomy: single centre experience in 111 patients with an acute cholecystitis
title_full_unstemmed Percutaneous cholecystostomy: single centre experience in 111 patients with an acute cholecystitis
title_short Percutaneous cholecystostomy: single centre experience in 111 patients with an acute cholecystitis
title_sort percutaneous cholecystostomy single centre experience in 111 patients with an acute cholecystitis
topic Gallbladder
interventional procedure – Cholecystitis
url https://www.jbsr.be/articles/101
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AT bpeters percutaneouscholecystostomysinglecentreexperiencein111patientswithanacutecholecystitis
AT msimoens percutaneouscholecystostomysinglecentreexperiencein111patientswithanacutecholecystitis
AT sbraak percutaneouscholecystostomysinglecentreexperiencein111patientswithanacutecholecystitis