Percutaneous Cholecystostomy for Suspected Acute Cholecystitis in the Hospitalized Patient

Ultrasound-guided percutaneous cholecystostomy in high-risk surgical patients

“…Four of the five non-responders in the present study had pericholecystic fluid on Us or CT compared with 12 of 46 (26%) in the responding group, which supports the theory of pericholecystic fluid as a negative predictor for response. However, others have suggested pericholecystic fluid to be a positive predictor [17,24] and still others are uncertain of its significance at all as small amounts of ascites are found in many severely ill patients [20]. Another suggested predictor of positive response has been right upper quadrant abdominal tenderness or pain [17,20]; this was confirmed in the present study.…”

“…The Us finding of gallstones has been proposed as a positive predictor [24,25]. In the present study, the response rate of patients with ACC was 93%, compared with 87% among patients with AAC.…”

“…In the present study, the response rate of patients with ACC was 93%, compared with 87% among patients with AAC. Previous studies have reported response rates of 63-93% [24,25] and 80% [25], respectively. AAC has been associated with a high incidence of gallbladder wall gangrene [9,14,25,26], in which a non-surgical treatment could be insufficient and an explanation of a lower response rate.…”

“…An overall success rate of 59-91% has been reported [20,22] for AAC and ACC combined. One reason for the variety in the response rate could be diagnostic difficulties, as the clinical picture can be diffuse and the Us findings inconclusive in severely ill patients [17,20,23,24]. Lack of response has sometimes been taken as a sign of incorrect diagnosis [16], suggesting the use of USGPC as a diagnostic tool.…”

Percutaneous Drainage with Ultrasound Guidance in the Intensive Care Unit

“…Some investigators have suggested that the Seldinger technique is more suitable for large abscess cavities and that the trocar technique is more suitable for small cavities (9,16). In this study, all of the catheters were placed using the Seldinger technique, regardless of the size of the cavity.…”