Operative tube versus percutaneous cholecystostomy for acute cholecystitis.
Publication/Presentation Date
7-1-1993
Abstract
The records of 26 patients who underwent cholecystostomy procedures for presumed acute cholecystitis during a 6-year period were reviewed. Nine patients had operative tube cholecystostomy (OC), and 17 patients had radiologic percutaneous cholecystostomy (PC). A correct diagnosis of acute cholecystitis was made in 22 of 26 patients (84%), including 14 of 17 PC patients and 8 of 9 in the OC group. The rate of resolution of cholecystitis was the same in each group (75% OC versus 78% PC). APACHE II scores prior to treatment were significantly higher in OC patients (20.9 OC versus 12.4 PC, p < 0.01). There were 5 deaths, including 3 in the OC groups and 2 in the PC group. Nonfatal complications were more frequent in the PC group. Two of the 14 correctly diagnosed PC patients (14%) subsequently required emergency cholecystectomy for persistent biliary sepsis, and 6 patients (43%) required at least 1 tube exchange for occlusion or dislodgement. Overall, only 5 of the 14 patients (36%) in the PC group were successfully treated without complications compared with 5 of 8 patients (63%) in the OC group. Despite its theoretical advantages, PC was no more effective than OC in the treatment of acute cholecystitis. These data suggest that OC remains a viable treatment option in critically ill patients with acute cholecystitis.
Volume
166
Issue
1
First Page
28
Last Page
31
ISSN
0002-9610
Published In/Presented At
Spain, D. A., Bibbo, C., Ecker, T., Nosher, J. L., & Brolin, R. E. (1993). Operative tube versus percutaneous cholecystostomy for acute cholecystitis. American journal of surgery, 166(1), 28–31. https://doi.org/10.1016/s0002-9610(05)80577-x
Disciplines
Medicine and Health Sciences
PubMedID
8328626
Department(s)
Department of Surgery
Document Type
Article