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PERCUTANEOUS CHOLECYSTOSTOMY IN THE MANAGEMENT OF ACUTE CHOLECYSTITIS
Author(s) -
Teoh William M. K.,
Cade Richard J.,
Banting Simon W.,
Mackay Sean,
Hassen A. Sayed
Publication year - 2005
Publication title -
anz journal of surgery
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.426
H-Index - 70
eISSN - 1445-2197
pISSN - 1445-1433
DOI - 10.1111/j.1445-2197.2005.03392.x
Subject(s) - medicine , cholecystostomy , cholecystectomy , acute cholecystitis , surgery , cholecystitis , sepsis , bile duct , malignancy , perforation , general surgery , percutaneous , mortality rate , gallbladder , retrospective cohort study , materials science , punching , metallurgy
Background: Percutaneous cholecystostomy (PC) has been used in managing acute cholecystitis in the setting of a patient with severe comorbidities where emergency cholecystectomy would carry significant mortality. The present study aims to assess the role, efficacy and complications of PC in acute cholecystitis. Methods: Retrospective review of case notes of patients who underwent PC at Box Hill Hospital, Melbourne, Australia between July 1997 and December 2002. Results: Sixteen patients (mean age 75 years; range 50–96) underwent PC. Indications for PC were significant comorbidities ( n = 6), failure of conservative treatment ( n = 4), bile duct malignancy ( n = 2), sepsis of unknown origin ( n = 2), patient declined surgery ( n = 1) and local perforation ( n = 1). Technical success rate was 94%. Clinical response to PC was observed in 15 patients. Overall mortality was 18% (3/16) with one death caused by PC failure. Interval cholecystectomy was performed in seven patients (44%). Conclusions: Percutaneous cholecystostomy is a useful alternative means of treating non‐resolving acute cholecystitis in circumstances where emergency surgery is hazardous. It also offers effective palliation in patients not suitable for subsequent surgery.