Clinical studyPercutaneous Cholecystostomy for Acute Cholecystitis: Ten-Year Experience
Section snippets
Materials and Methods
Between January 2000 and February 2010, 110 patients underwent percutaneous cholecystostomy at a single quaternary-care medical center. Medical records were available for 106 patients, who formed the basis of this retrospective study, which was conducted with the approval of the institutional review board. All data were handled in accordance with the Health Insurance Portability and Accountability Act.
The diagnosis of acute cholecystitis was based on the combination of clinical presentation,
Results
There were 42 women and 64 men (mean age, 66 y; range, 23–96 y; Table 4). There were no significant differences in sex, age, presentation setting (ED vs inpatient), or comorbid conditions (all P > 0.2; Table 5). Seventy-one patients (67%) were outpatients presenting to the ED, and 35 (23%) were inpatients who had been admitted for other reasons.
The average length of time from the onset of symptoms to initiation of antibiotic treatment for all patients was 32 hours (range, 1 h to 9 d), and the
Discussion
Since the first description of a safe technique for percutaneous cholecystostomy published by Radder in 1980 (8), radiologic intervention has proven to be an effective first-line therapeutic procedure for the treatment of acute cholecystitis, particularly when patients are too ill for surgery or when the time course of their illness requires a period of defervescence before cholecystectomy (9, 10, 11). Even for patients assigned to American Society of Anesthesiologists classes III, IV, and V (6
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2018, Journal of Surgical ResearchCitation Excerpt :The literature has thus far been unclear about the optimal patient selection for, as well as guiding the clinical care of patients following, PC tube placement. Furthermore, clinical outcomes have largely only been assessed in limited populations such as patients in Veterans Affairs hospitals, abroad at institutions with treatment protocols that are different than those in the United States, or in institutions of a primarily single demographic group.8-11 In this study, we aim to describe patient characteristics leading to PC tube placement, compare outcomes in patients with PC tube placement due to acute versus chronic PPR, identify predictors of disease recurrence, and identify predictors of interval CCY and characteristics associated with PC tube placement as a safe and definitive treatment for AC in a diverse, urban patient population.
None of the authors have identified a conflict of interest.
This article includes two supplementary tables that are available online at www.jvir.org.