Percutaneous cholecystostomy drainage for the treatment of acute emphysematous cholecystitis.

Vingan, Harlan; Wohlgemuth, Stephen D.; Bell, James

doi:10.2214/ajr.155.5.2120927

Cited by 23 publications

(7 citation statements)

References 5 publications

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“…21,28 Because many patients have inoperable conditions, percutaneous cholecystostomy is an effective treatment for cholecystitis. One study suggests that percutaneous cystic duct stent placement may be considered as a treatment option.…”

Section: Discussionmentioning

confidence: 99%

Risk factors for cholecystitis after metal stent placement in malignant biliary obstruction

Suk

Kim

et al. 2006

Gastrointestinal Endoscopy

142

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Section: Discussionmentioning

confidence: 99%

Risk factors for cholecystitis after metal stent placement in malignant biliary obstruction

Suk

Kim

et al. 2006

Gastrointestinal Endoscopy

142

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“…Recently, PC was introduced to decrease morbidity and mortality in surgically high-risk patients with acute cholecystitis and to lead to safer elective surgery [6,8,11]. More specific indications include decompression of the GB in acute cholecystitis, obstructive jaundice, hemorrhagic or emphysematous cholecystitis, and GB perforation [12,13,14,15].…”

Section: Discussionmentioning

confidence: 99%

Acute cholecystitis in high-risk patients: percutaneous cholecystostomy vs conservative treatment

et al. 2002

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Our objective was to compare the effectiveness of percutaneous cholecystostomy (PC) vs conservative treatment (CO) in high-risk patients with acute cholecystitis. The study was randomized and comprised 123 high-risk patients with acute cholecystitis. All patients fulfilled the ultrasonographic criteria of acute inflammation and had an APACHE II score > or =12. Percutaneous cholecystostomy guided by US or CT was successful in 60 of 63 patients (95.2%) who comprised the PC group. Sixty patients were conservatively treated (CO group). One patient died after unsuccessful PC (1.6%). Resolution of symptoms occurred in 54 of 63 patients (86%). Eleven patients (17.5%) died either of ongoing sepsis (n=6) or severe underlying disease (n=5) within 30 days. Seven patients (11%) were operated on because of persisting symptoms (n=3), catheter dislodgment (n=3), or unsuccessful PC (n=1). Cholecystolithotripsy was performed in 5 patients (8%). Elective surgery was performed in 9 cases (14%). No further treatment was needed in 32 patients (51%). In the CO group, 52 patients (87%) fully recovered and 8 patients (13%) died of ongoing sepsis within 30 days. All successfully treated patients showed clinical improvement during the first 3 days of treatment. Percutaneous cholecystostomy in high-risk patients with acute cholecystitis did not decrease mortality in relation to conservative treatment. Percutaneous cholecystostomy might be suggested to patients not presenting clinical improvement following 3 days of conservative treatment, to critically ill intensive care unit patients, or to candidates for percutaneous cholecystolithotripsy.

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“…Treatment includes prompt surgery, with cholecystectomy been the definitive one, although percutaneous cholecystostomy may be used as an initial temporizing procedure in critically ill patients 11 . In addition to surgery, broad-spectrum antimicrobial therapy, and correction of associated underlying conditions such as acid-base and electrolyte imbalances, hypovolemia, and hyperglycemia must be considered.…”

Section: Discussionmentioning

confidence: 99%

Emphysematous cholecystitis

Lupinacci¹,

Chafaı̈²,

Tiret³

2009

ABCD, arq. bras. cir. dig.

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BACKGROUND: Emphysematous cholecystitis is life-threatening condition characterized by gas-forming infection of the gallbladder. It is mostly seems in old male patients with systemic, specially diabetes and vascular diseases. CASE REPORT: - A 30-year-old man without previous diseases was admitted because of right upper quadrant pain and nausea. On admission the patient was febrile (38.7o) with normal bilirubin levels. The white blood count was 26700/µl and reactive protein C was 470. Axial sections of single slice computed tomography imaging (section thickness 5 mm), revealed gallbladder wall enhancement after i.v. contrast, as well as dilatation of the gallbladder with intraluminal air. The patient underwent open cholecystectomy. The culture of the bile showed clostridium perfringes. The postoperative course of the patient was uneventful. CONCLUSION: This is a rare form of cholecystitis that carries a high mortality and usually present insidious clinical signs. CT is the most accurate imaging technique. Antibiotic therapy should begin quickly and include coverage of common pathogens, particularly Clostridia. Surgical intervention should take place as early as possible.

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Percutaneous cholecystostomy drainage for the treatment of acute emphysematous cholecystitis.

Cited by 23 publications

References 5 publications

Risk factors for cholecystitis after metal stent placement in malignant biliary obstruction

Risk factors for cholecystitis after metal stent placement in malignant biliary obstruction

Acute cholecystitis in high-risk patients: percutaneous cholecystostomy vs conservative treatment

Emphysematous cholecystitis

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