The role of percutaneous transhepatic cholecystostomy in the management of acute cholecystitis in high-risk patients

R. Avrahami, E. Badani, S. Watemberg, I. Nudelman, A. A. Deutsch, E. Rabin, M. Goren, M. Neuman-Levin

Research output: Contribution to journalArticlepeer-review

Abstract

A method recently developed that may be an appropriate solution for high-risk patients with acute cholecystitis is percutaneous sonography-guided cholecystostomy. We report our experience in 10 high-risk elderly patients with clinical and sonographic diagnosis of acute cholecystitis. Immediate regression and resolution of septic symptoms was achieved in all cases. One patient was operated on as soon as his clinical condition stabilized, with uneventful postoperative recovery. The other nine were considered inoperable; of these, two were readmitted within a few months with recurrence of symptoms who underwent surgery, with a long and complicated postoperative course. The only complication we observed was temporary septicemia in one patient immediately after completion of the procedure. In view of these findings, we consider percutaneous transhepatic cholecystostomy an effective and safe method of treatment for acute cholecystitis in critically ill patients. However, this procedure should be regarded as a preliminary measure only, to render the patient more suitable for a formal cholecystectomy. We report our results and discuss technical and principal matters concerning percutaneous transhepatic cholecystostomy in the light of the current literature.

Original languageEnglish
Pages (from-to)111-114
Number of pages4
JournalInternational Surgery
Volume80
Issue number2
StatePublished - 1995
Externally publishedYes

Keywords

  • Cholecystitis acute
  • Cholecystotomy
  • High-risk patients

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