Cholecystostomy Treatment in an ICU Population: Complications and Risks

Friedrich, Ann-Kristin U.; Baratta, Kevin P.; Lewis, Joanne; Karam, Adib R.; Hudlin, Margaret; Litwin, Demetrius E. M.; Cahan, Mitchell A.

doi:10.1097/sle.0000000000000319

Cited by 15 publications

(6 citation statements)

References 44 publications

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“…The overall procedure-related complication rate varies in broad intervals; the majority of articles report the incidence under 20%. Some studies report an overall complication rate of up to 69% [17]. Our experience corresponds to a 20% level.…”

Section: Discussionsupporting

confidence: 49%

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Percutaneous cholecystostomy in the management of acute cholecystitis - 10 years of experience.

Dvorák¹,

Hoffmann²,

Renc³

et al. 2019

Videosurgery and Other Miniinvasive Techniques

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A b s t r a c tIntroduction: The preferred treatment for acute cholecystitis is cholecystectomy, but for patients with precluded general anesthesia due to critical illness or multiple medical comorbidities it is not suitable. Cholecystostomy could be a minimally invasive therapeutic alternative. Aim: To retrospectively evaluate the indications, technical features, efficacy, complications, patients' development and relationships among monitored parameters of percutaneous computed tomography (CT)-guided cholecystostomies in cases of acute cholecystitis and find the role of this procedure in appropriate treatment selection. Material and methods: Over the course of 10 years, 75 percutaneous cholecystostomy procedures in 69 patients were performed in cases with diagnosed acute cholecystitis, precluded general anesthesia and contraindicated cholecystectomy by an experienced surgeon and anesthesiologist. These interventions were done using only local anesthesia. The patients were men in 39 cases and women in 33 cases, aged 33 to 91 years. Results: Technical success was achieved in all cases. The indications were sepsis in 34 (45.3%) cases, bridging acute gallbladder inflammatory status in 15 (20%) interventions, serious medical comorbidities in 8 (10.7%) cases, disseminated malignancy and cardiac failure in 6 cases each (both 8%) and neurological affections in 5 (6.5%) cases. Cholecystostomy was frequently the final solution in acalculous cholecystitis (79.3%). The 30-day mortality rate was determined at 10.7% and the overall complication rate was 21.3%, but all of these complications were managed conservatively or using minimally invasive treatment. Conclusions: Percutaneous CT-guided cholecystostomy is reserved for patients with a serious medical status for various reasons that preclude surgical treatment and general anesthesia. Simultaneously, technical success and efficacy are high and the complication rate is acceptable.

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Section: Discussionsupporting

confidence: 49%

“…The clinically successful effect reaches up to 85–92% [15, 16]. Therapeutic failure immediately followed by the surgery is reported in less than 5% [17] of cases. The 30-day mortality rate is reported to be between 0 and 25% [18–20].…”

Section: Discussionmentioning

confidence: 99%

Percutaneous cholecystostomy in the management of acute cholecystitis - 10 years of experience.

Dvorák¹,

Hoffmann²,

Renc³

et al. 2019

Videosurgery and Other Miniinvasive Techniques

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“…The reported incidence of PC-related complications varies from 2.5 to 69% (15, 20,25,38,49,[66][67][68]. Among all the complications, dislodgement of the cholecystostomy tube is the most common occurrence, which can account for more than half of all events in some publications (20,27,38,66,68). Apart from tube dislodgement, bile leakage is another common complication (12, 15, 49, 61, 68).…”

Section: Pc-associated Complications and Care Complicationsmentioning

confidence: 99%

Management of Patients With Acute Cholecystitis After Percutaneous Cholecystostomy: From the Acute Stage to Definitive Surgical Treatment

Hung

Sung

et al. 2021

Front. Surg.

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Percutaneous cholecystostomy (PC) has become an important procedure for the treatment of acute cholecystitis (AC). PC is currently applied for patients who cannot undergo immediate laparoscopic cholecystectomy. However, the management following PC has not been well-reviewed. The efficacy of PC tubes has already been indicated, and compared to complications of other invasive biliary procedures, complications related to PC are rare. Following the resolution of AC, patients who can tolerate anesthesia and the surgical risk should undergo interval cholecystectomy to reduce the recurrence of biliary events. For patients unfit for surgery, whether owing to comorbidities, anesthesia risks, or surgical risks, expectant management may be applied; however, a high incidence of recurrence has been noted. In addition, several interesting issues, such as the indications for cholangiography via the PC tube, removal or maintenance of the PC catheter before definitive treatment, and timing of elective surgery, are all discussed in this review, and a relevant decision-making flowchart is proposed. PC is an effective and safe intervention, whether as expectant treatment or bridge therapy to definitive surgery. High-level evidence of post-PC care is still necessary to modify current practices.

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“…Percutaneous cholecystostomy is a treatment strategy that can be used in patients with acute cholecystitis, especially in patients with high ASA scores, and can also be used as a bridge to elective treatment. Despite its low morbidity and mortality rates, it includes risks such as hemorrhage, liver abscess, and recurrence of symptoms 20,21 . Especially during the pandemic period, it may be thought that the risk of suffering from morbid and mortal complications of COVID-19 disease for elderly people has increased, and the tendency to this treatment strategy may have increased in order to mitigate disease transmission 22 .…”

Section: Discussionmentioning

confidence: 99%

Comparison of outcomes of the patients with acute cholecystitis treated in the COVID-19 pandemic and pre-pandemic period

Lapsekili

Buldanlı

Peker

2021

Rev. Assoc. Med. Bras.

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Cholecystostomy Treatment in an ICU Population: Complications and Risks

Cited by 15 publications

References 44 publications

Percutaneous cholecystostomy in the management of acute cholecystitis - 10 years of experience.

Percutaneous cholecystostomy in the management of acute cholecystitis - 10 years of experience.

Management of Patients With Acute Cholecystitis After Percutaneous Cholecystostomy: From the Acute Stage to Definitive Surgical Treatment

Comparison of outcomes of the patients with acute cholecystitis treated in the COVID-19 pandemic and pre-pandemic period

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