Percutaneous cholecystostomy for acute cholecystitis in high-risk patients

experience of a surgeon-initiated interventional program

Eric J. Silberfein, Wei Zhou, Panagiotis Kougias, Hosam F. El Sayed, Tam T. Huynh, Daniel Albo, David H. Berger, F. Charles Brunicardi, Peter H. Lin

Research output: Contribution to journalArticle

24 Citations (Scopus)

Abstract

Background: The treatment of choice for acute cholecystitis is cholecystectomy. However, percutaneous cholecystostomy (PC) is an alternative treatment in patients who are at high risk for urgent surgery. This study reviews our experience of PC for treatment of acute cholecystitis in a surgeon-initiated interventional program. Methods: Clinical records of all high-risk patients who underwent PC placement by surgeons (group A; n = 22) for acute cholecystitis were reviewed. Treatment outcomes were compared with patients who underwent PC by interventional radiologists (group B; n = 26). Results: Similar technical success, procedural complication, or treatment outcome were noted between the two groups. Seven patients (32%) in group A and 9 patients (35%) in group B underwent delayed elective cholecystectomy surgery. The time elapsed between the diagnosis to PC placement in groups A and B was 6.6 ± 3.5 hours and 18.5 ± 4.3 hours, respectively (P < .02). Conclusions: Ultrasound-guided PC is a safe and effective treatment for acute cholecystitis in high-risk surgical patients. Surgeons with endovascular skills can obtain clinical competence in this catheter-based procedure, which provides an added armamentarium in surgical biliary disease management.

Original languageEnglish (US)
Pages (from-to)672-677
Number of pages6
JournalAmerican Journal of Surgery
Volume194
Issue number5
DOIs
StatePublished - Nov 1 2007
Externally publishedYes

Fingerprint

Cholecystostomy
Acute Cholecystitis
Cholecystectomy
Clinical Competence
Therapeutics
Disease Management
Surgeons
Catheters

Keywords

  • Acute cholecystitis
  • Biliary drainage
  • Cholangitis
  • Endovascular
  • Laparoscopic cholecystectomy
  • Percutaneous cholecystostomy

ASJC Scopus subject areas

  • Surgery

Cite this

Percutaneous cholecystostomy for acute cholecystitis in high-risk patients : experience of a surgeon-initiated interventional program. / Silberfein, Eric J.; Zhou, Wei; Kougias, Panagiotis; El Sayed, Hosam F.; Huynh, Tam T.; Albo, Daniel; Berger, David H.; Brunicardi, F. Charles; Lin, Peter H.

In: American Journal of Surgery, Vol. 194, No. 5, 01.11.2007, p. 672-677.

Research output: Contribution to journalArticle

Silberfein, Eric J. ; Zhou, Wei ; Kougias, Panagiotis ; El Sayed, Hosam F. ; Huynh, Tam T. ; Albo, Daniel ; Berger, David H. ; Brunicardi, F. Charles ; Lin, Peter H. / Percutaneous cholecystostomy for acute cholecystitis in high-risk patients : experience of a surgeon-initiated interventional program. In: American Journal of Surgery. 2007 ; Vol. 194, No. 5. pp. 672-677.
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abstract = "Background: The treatment of choice for acute cholecystitis is cholecystectomy. However, percutaneous cholecystostomy (PC) is an alternative treatment in patients who are at high risk for urgent surgery. This study reviews our experience of PC for treatment of acute cholecystitis in a surgeon-initiated interventional program. Methods: Clinical records of all high-risk patients who underwent PC placement by surgeons (group A; n = 22) for acute cholecystitis were reviewed. Treatment outcomes were compared with patients who underwent PC by interventional radiologists (group B; n = 26). Results: Similar technical success, procedural complication, or treatment outcome were noted between the two groups. Seven patients (32{\%}) in group A and 9 patients (35{\%}) in group B underwent delayed elective cholecystectomy surgery. The time elapsed between the diagnosis to PC placement in groups A and B was 6.6 ± 3.5 hours and 18.5 ± 4.3 hours, respectively (P < .02). Conclusions: Ultrasound-guided PC is a safe and effective treatment for acute cholecystitis in high-risk surgical patients. Surgeons with endovascular skills can obtain clinical competence in this catheter-based procedure, which provides an added armamentarium in surgical biliary disease management.",
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