Percutaneous cholecystostomy as a bridge therapy in the geriatric age group with acute cholecystitis.
Acute cholecystitis
Cholecystectomy
Comorbidity
Geriatrics
Percutaneous cholecystostomy
Journal
Irish journal of medical science
ISSN: 1863-4362
Titre abrégé: Ir J Med Sci
Pays: Ireland
ID NLM: 7806864
Informations de publication
Date de publication:
27 Oct 2023
27 Oct 2023
Historique:
received:
14
09
2023
accepted:
09
10
2023
medline:
27
10
2023
pubmed:
27
10
2023
entrez:
27
10
2023
Statut:
aheadofprint
Résumé
The aim of this study was to investigate the efficacy of percutaneous cholecystostomy (PC) in the geriatric patients with acute cholecystitis. The records of geriatric patients with high surgical risk who underwent percutaneous cholecystostomy for acute cholecystitis were reviewed retrospectively. The median age of 134 patients who underwent percutaneous cholecystostomy was 77 (65-98) years and 63.4% were women. The mean length of hospital stay was 5 (4-18) days, and the follow-up period until the procedure was 2 (1-6) days. Murphy's sign was positive in 79.1% of patients on physical examination, and the remaining patients (20.9%) had only tenderness on examination. As USG findings, 59.0% of the patients had a gall bladder wall thickness (> 4 mm) with pericholecystic fluid. Additional imaging method, abdominal CT, was performed in 29 patients (21.6%), MRCP was performed in three patients (2.2%), and ERCP was performed in one patient (0.7%). Bacterial growth was detected in 27.6% of the bile cultures performed. During the follow-up period, laparoscopic cholecystectomy was performed in 60.4% of the patients and open cholecystectomy was performed in 5.2% of the patients electively. 34.3% of the patients did not undergo any surgery. Bile leakage was detected in two patients (1.5%) as a procedure-related complication, and no mortality was observed. Abdominal ultrasonography-guided PC is a safe and effective method in the management of acute cholecystitis in high-risk patients in the geriatric age group.
Identifiants
pubmed: 37889395
doi: 10.1007/s11845-023-03550-z
pii: 10.1007/s11845-023-03550-z
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Informations de copyright
© 2023. The Author(s), under exclusive licence to Royal Academy of Medicine in Ireland.
Références
Ozkan E, Fersahoğlu MM, Dulundu E et al (2010) Factors affecting mortality and morbidity in emergency abdominal surgery in geriatric patients. Ulus Travma Acil Cerrahi Derg 16:439–444
pubmed: 21038122
Nishida K, Okinaga K, Miyazawa Y et al (2000) Emergency abdominal surgery in patients aged 80 years and older. Surg Today 30:22–27
doi: 10.1007/PL00010041
pubmed: 10648078
Loozen CS, van Ramshorst B, van Santvoort HC, Boerma D (2017) Early cholecystectomy for acute cholecystitis in the elderly population: a systematic review and meta-analysis. Dig Surg 34(5):371–379
doi: 10.1159/000455241
pubmed: 28095385
Rice CP, Vaishnavi KB, Chao C et al (2019) Operative complications and economic outcomes of cholecystectomy for acute cholecystitis. World J Gastroenterol 25(48):6916–6927. https://doi.org/10.3748/wjg.v25.i48.6916
doi: 10.3748/wjg.v25.i48.6916
pubmed: 31908395
pmcid: 6938729
Frazee RC, Nagorney DM, Mucha P Jr (1989) Acute calculous cholecystitis. Mayo Clin Proc 64:163–167
doi: 10.1016/S0025-6196(12)65670-5
pubmed: 2921875
Radder RW (1980) Ultrasonically guided percutaneous catheter drainage for gallbladder empyema. Diagn Imaging 49:330–333
pubmed: 7215096
Yokoe M, Hata J, Takada T et al (2018) Tokyo Guidelines 2018: diagnostic criteria and severity grading of acute cholecystitis (with videos). J Hepatobiliary Pancreat Sci 25(1):41–54
doi: 10.1002/jhbp.515
pubmed: 29032636
Davis CA, Landercasper J, Gundersen LH, Lambert PJ (1999) Effective use of percutaneous cholecystostomy in high risk surgical patients: techniques, tube management. Arch Surg 134(7):727–731; discussion 731-2
doi: 10.1001/archsurg.134.7.727
pubmed: 10401823
Arellano RS (2011) Biliary Interventions. Non-vascular interventional radiology of the abdomen. Springer Science+Business Media LLC. p 83–101
Boland GW, Lee MJ, Leung J, Mueller PR (1994) Percutaneous cholecystostomy in critically ill patients: early response and final outcome in 82 patients. AJR Am J Roentgenol 163:339–34220
doi: 10.2214/ajr.163.2.8037026
pubmed: 8037026
Festi D, Dormi A, Capodicasa S et al (2008) Incidence of gallstone disease in Italy: results from a multicenter, population-based Italian study (the MICOL project). World J Gastroenterol 14:5282–5289
doi: 10.3748/wjg.14.5282
pubmed: 18785280
pmcid: 2744058
Halldestam I, Enell EL, Kullman E, Borch K (2004) Development of symptoms and complications in individuals with asymptomatic gallstones. Br J Surg 91:734–738
doi: 10.1002/bjs.4547
pubmed: 15164444
Siegel JH, Kasmin FE (1997) Biliary tract diseases in the elderly: management and outcomes. Gut 41:433–435
doi: 10.1136/gut.41.4.433
pubmed: 9391238
pmcid: 1891511
Macrì A, Scuderi G, Saladino E et al (2006) Acute gallstone cholecystitis in the elderly: treatment with emergency ultrasonographic percutaneous cholecystostomy and interval laparoscopic cholecystectomy. Surg Endosc 20:88–91
doi: 10.1007/s00464-005-0178-6
pubmed: 16333552
Atar E, Bachar GN, Berlin S et al (2014) Percutaneous cholecystostomy in critically ill patients with acute cholecystitis: complications and late outcome. Clin Radiol 69(6):e247–e252
doi: 10.1016/j.crad.2014.01.012
pubmed: 24594378
Pessaux P, Regenet N, Tuech JJ et al (2001) Laparoscopic versus open cholecystectomy: a prospective comparative study in the elderly with acute cholecystitis. Surg Laparosc Endosc Percutan Tech 11:252–255
doi: 10.1097/00129689-200108000-00005
pubmed: 11525370
Soria Aledo V, Galindo Iniguez L, Flores Funes D (2017) Is cholecystectomy the treatment of choice for acute acalculous cholecystitis? A systematic review of the literature. Rev Esp Enferm Dig 109:708–718
doi: 10.17235/reed.2017.4902/2017
pubmed: 28776380
Akıncı D, Akhan O, Özmen M et al (2004) Yüksek cerrahi riskli hasta grubunda perkütan kolesistostomi sonuçları. Tanı Girişim Radyo 10:323–327
Hatzidakis AA (2011) Percutaneous biliary drainage and stenting. In: Gervais DA, Sabharwal T (eds) Interventional Radiology Procedures in Biopsy and Drainage, 1st edn. Springer-Verlag, London Limited, New York, pp 143–153
Sanaiha Y, Juo YY, Rudasill SE et al (2020) Percutaneous cholecystostomy for grade III acute cholecystitis is associated with worse outcomes. Am J Surg 220(1):197–202
doi: 10.1016/j.amjsurg.2019.11.025
pubmed: 31812256
Chung H-Y, Hsu C-C, Hung Y-L et al (2021) Alternative application of percutaneous cholecystostomy in patients with biliary obstruction. Abdom Radiol (NY) 46(6):2891–2899. https://doi.org/10.1007/s00261-020-02898-5 . Epub 2021 Jan 2
doi: 10.1007/s00261-020-02898-5
pubmed: 33388808
Chopra S, Dodd DG, Mumbover AL et al (2001) Treatment of acute cholecystitis in non-critically ill patients at high surgical risk: comparison of clinical outcomes after gallbladder aspiration and percutaneous cholecystostomy. AJR Am J Roentgenol 176:1025–1031
doi: 10.2214/ajr.176.4.1761025
pubmed: 11264103
England RE, McDermott VG, Smith TP et al (1997) Percutaneous cholecystostomy: who responds? AJR Am J Roentgenol 168:1247–1251
doi: 10.2214/ajr.168.5.9129421
pubmed: 9129421
Sung PY, Hyung S (2018) Clinical aspects of bile culture in patients undergoing laparoscopic cholecystectomy. Medicine (Baltimore) 97(26)
Koebrugge B, vanLeuken M, Ernst MF et al (2010) Percutaneous cholecystostomy in critically ill patients with a cholecystitis: a safe option. Dig Surg 27:417–421
doi: 10.1159/000308460
pubmed: 20948216
Abdulaal AF, Sharouda SK, Mahdy HA (2014) Percutaneous cholecystostomy treatment for acute cholecystitis in high risk patients. Egypt J Radiol Nucl Med 45(4):1133–1139. https://doi.org/10.1016/j.ejrnm.2014.07.001
doi: 10.1016/j.ejrnm.2014.07.001
Albir MG, Gorgojo VM, Perdom R et al (2020) Acute cholecystitis in elderly and high-risk surgical patients: is percutaneous cholecystostomy preferable to emergency cholecystectomy? J Gastrointest Surg. https://doi.org/10.1007/s11605-019-04424-5
doi: 10.1007/s11605-019-04424-5
Horn T, Christensen SD, Kirkegård J et al (2015) Percutaneous cholecystostomy is an effective treatment option for acute calculous cholecystitis: a 10-year experience. HPB (Oxford) 17(4):326–331. https://doi.org/10.1111/hpb.12360
doi: 10.1111/hpb.12360
pubmed: 25395238