Percutaneous cholecystostomy in critically ill patients with acute cholecystitis: Complications and late outcome

Atar, Eli; Bachar, Gideon; Berlin, S.; Neiman, Chaim; Bleich-Belenky, E.; Litvin, Sergey; Knihznik, M.; Belenky, Alexander; Ram, Edward

doi:10.1016/j.crad.2014.01.012

Cited by 62 publications

(47 citation statements)

References 21 publications

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“…They demonstrated a post-surgery rate of 5.6% and mortality rate was 2.8%, both signiicantly lower than found in the literature [4].…”

Section: Discussionmentioning

confidence: 55%

“…Atara et al found the success rate to be as high as 79% in their study [4]. Patients with clinical signs and localized symptoms to the right upper quadrant are more likely to respond to PC.…”

Section: Discussionmentioning

confidence: 96%

“…A diagnostic test in 1921 placed dye in the gallbladder by way of a cholecystostomy tube. Percutaneous cholecystostomy was irst described by Radder as an alternative to immediate open or laparoscopic cholecystectomy on the basis that initial drainage of the gallbladder will result in decompression of the biliary system and subsequent resolution of gallbladder inlammation [4]. He then performed the irst percutaneous cholecystostomy (PC) using ultrasound guidance in 1979 for empyema of the gallbladder [6].…”

Section: Historymentioning

confidence: 99%

“…The method used for placement was proven to be unrelated to rates of dislodgement [14]. The locking loop catheters are preferred to reduce the risk of dislodgment as the catheter dislodgment tends to occur in a higher rate here Bedside Percutaneous Cholecystostomy http://dx.doi.org/10.5772/intechopen.70500than in other organs [4,9]. This is mostly due to the degree of respiratory motion at this location in the abdomen and, in the author's experience, is encountered less frequently with the intercostal approach compared with the subcostal approach.…”

Section: Complicationsmentioning

confidence: 99%

“…In patients with acalculous cholecystitis, PC can obviate the need for surgery [1,2]. Furthermore, it makes possible the ability to perform diagnostic cholangiography and access for intervention to eliminate common bile duct stones [4]. Options for image guidance include ultrasound, computed tomography, and luoroscopy.…”

Section: Introductionmentioning

confidence: 99%

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Although percutaneous cholecystostomy historically is an alternative to cholecystectomy, it is typically performed as a bridge to gallbladder removal. As a low mortality procedure, it proves itself a valuable tool in morbid patients such as the elderly and the critically ill who present with acute cholecystitis and as an alternate route for biliary access. In high-risk patients, PC can be performed at the patient's bedside in patients who are too unstable to be transported outside the ICU. PC is performed using ultrasound, CT, or luoroscopic guidance; however, bedside PC can only be performed using ultrasound. Ultrasound is readily available and portable and allows for real-time imaging. A 2010 study performed by Donkol et al. demonstrated success rates for CT (93%), US (46%), and luoroscopy (62%). Though US had the lowest success rate, it remains the only option for those critically ill who cannot tolerate transportation or an immediate cholecystectomy. Contraindications of PC include hemorrhage, pericholecystic abscess, gallbladder tumor, etc. Complications include bile leak, hemorrhage, sepsis, bowel perforation, etc. The gallbladder is a small organ with much pathology. Having the knowledge and skill to adequately perform this procedure is essential, especially in patients with septic shock in need of source control.

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“…They demonstrated a post-surgery rate of 5.6% and mortality rate was 2.8%, both signiicantly lower than found in the literature [4].…”

Section: Discussionmentioning

confidence: 55%

Section: Discussionmentioning

confidence: 96%