US-guided cholecystostomy: a retrospective study of indications, complications and outcome
ResumoWe aimed to review the use of US-guided percutaneous cholecystostomy (PC) in our hospital: the indications, complications and outcomes.
We retrospectively reviewed consecutive PC procedures performed at our institution from January 2010 to December 2012.
Sixty-five patients (36 male, 29 female; mean age 75 years) underwent 70 US-guided PC, mainly in the context of acute cholecystitis (62/65 – 95,4%). The diagnosis of acute cholecystitis was confirmed just by US in 32/62 (51,6%). The main indications for PC were the persistence of clinical and/or laboratory findings after antibiotherapy institution and the presence of comorbidities.
The transhepatic procedure was considered technically successful in 69/70 (98,6%) cases. We had 2/70 (2,8%) major complications (1biliary peritonitis; 1 fatal abdominal wall abscess with sepsis) and 7/70 (10,0%) minor complications (6 dislodgements; 1 phrenic nerve irritation). Thirty-day mortality was 6,2% (4 patients, 1 procedure related). The average
duration of catheter drainage was 21,4 days (range, 2-60 days). Subsequently, 24/65 (36,9%) patients underwent elective cholecystectomy
(mean 4 months, range 1,5-10). Recurrent acute cholecystitis occurred in 8/65 (12,3%) patients during the follow-up.
US-guided PC is a viable option for treating acute cholecystitis in some specific clinical settings.
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