US-guided cholecystostomy: a retrospective study of indications, complications and outcome

Autores

  • Filipa Vilaverde Centro Hospitalar de Entre o Douro e Vouga, Feira
  • Marta Sousa Centro Hospitalar de Entre o Douro e Vouga, Feira
  • Romeu Mesquita Centro Hospitalar de Entre o Douro e Vouga, Feira
  • Joana Pinto Centro Hospitalar de Entre o Douro e Vouga, Feira
  • Alcinda Reis Centro Hospitalar de Entre o Douro e Vouga, Feira

DOI:

https://doi.org/10.25748/arp.13251

Resumo

We 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.

Biografias Autor

Filipa Vilaverde, Centro Hospitalar de Entre o Douro e Vouga, Feira

Serviço de Imagiologia

Marta Sousa, Centro Hospitalar de Entre o Douro e Vouga, Feira

Serviço de Imagiologia

Romeu Mesquita, Centro Hospitalar de Entre o Douro e Vouga, Feira

Serviço de Imagiologia

Joana Pinto, Centro Hospitalar de Entre o Douro e Vouga, Feira

Serviço de Imagiologia

Alcinda Reis, Centro Hospitalar de Entre o Douro e Vouga, Feira

Serviço de Imagiologia

Referências

Yokoe M, Takada T, Strasberg SM, Solomkin JS, Mayumi T, Gomi H, Pitt HA, Gouma DJ, Garden OJ, Buchler MW, Kiriyama S, Kimura Y, et al. New diagnostic criteria and severity assessment of acute cholecystitis in revised Tohyo guidelines. J Hepatobiliary Pancreat Sci. 2012,19:578-85.

Miura F, Yokoe M, Takada T, Kawarada Y, Nimura Y, Wada K, et al. Flowcharts for the diagnosis and treatment of acute cholecystitis: Tokyo guidelines. J Hepatobiliary Pancreat Sci. 2007,14:27-34.

Huber DF, Edward W, Cooperman M. Cholecystectomy in elderly patients. Am J Surg. 1983,146:719-22.

Escarce JJ, Shea JA, Chen W, Qian Z, Schwartz JS. Outcomes of open cholecystectomy in the elderly: a longitudinal analysis of 21,000 cases in the prelaparoscopic era. Surgery. 1995,117:156-64.

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Publicado

2017-10-16

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