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Surgeon-performed point-of-care ultrasound for acute cholecystitis: indications and limitations: a European Society for Trauma and Emergency Surgery (ESTES) consensus statement

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A Correction to this article was published on 08 November 2019

This article has been updated

Abstract

Background

Acute cholecystitis (AC), frequently responsible for presentation to the emergency department, requires expedient diagnosis and definitive treatment by a general surgeon. Ultrasonography, usually performed by radiology technicians and reported by radiologists, is the first-line imaging study for the assessment of AC. Targeted point-of-care ultrasound (POCUS), particularly in the hands of the treating surgeon, may represent an evolution in surgical decision-making and may expedite care, reducing morbidity and cost.

Methods

This consensus guideline was written under the auspices of the European Society of Trauma and Emergency Surgery (ESTES) by the POCUS working group. A systematic literature search identified relevant papers on the diagnosis and treatment of AC. Literature was critically-appraised according to the GRADE evidence-based guideline development method. Following a consensus conference at the European Congress of Trauma & Emergency Surgery (Valencia, Spain, May 2018), final recommendations were approved by the working group, using a modified e-Delphi process, and taking into account the level of evidence of the conclusion.

Recommendations

We strongly recommend the use of ultrasound as the first-line imaging investigation for the diagnosis of AC; specifically, we recommend that POCUS may be adopted as the primary imaging adjunct to surgeon-performed assessment of the patient with suspected AC. In line with the Tokyo guidelines, we strongly recommend Murphy’s sign, in conjunction with the presence of gallstones and/or wall thickening as diagnostic of AC in the correct clinical context. We conditionally recommend US as a preoperative predictor of difficulty of cholecystectomy. There is insufficient evidence to recommend contrast-enhanced ultrasound or Doppler ultrasonography in the diagnosis of AC. We conditionally recommend the use of ultrasound to guide percutaneous cholecystostomy placement by appropriately-trained practitioners.

Conclusions

Surgeons have recently embraced POCUS to expedite diagnosis of AC and provide rapid decision-making and early treatment, streamlining the patient pathway and thereby reducing costs and morbidity.

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Change history

  • 08 November 2019

    Unfortunately, the author Luca Ponchietti was omitted in the original publication. Please find the correct author list here.

References

  1. Zacks S. A population-based cohort study comparing laparoscopic cholecystectomy and open cholecystectomy. Am J Gastroenterol. 2002;97(2):334–40.

    Article  PubMed  Google Scholar 

  2. Keus F, de Jong J, Gooszen H, Laarhoven C. Laparoscopic versus open cholecystectomy for patients with symptomatic cholecystolithiasis. Cochrane Datab Syst Rev. 2004;2006:4.

    Google Scholar 

  3. Chau C, Tang C, Ha P, Kwok S, Yau K, Li M, et al. Laparoscopic cholecystectomy for acute cholecystitis: the evolving trend in an institution. Asian J Surg. 2006;29(3):120–4.

    Article  PubMed  Google Scholar 

  4. Malla B, Shrestha R. Laparoscopic cholecystectomy: complication and conversion rate. Kathmandu Univ Med J. 2012;8:4.

    Google Scholar 

  5. Sanjay P, Weerakoon R, Shaikh I, Bird T, Paily A, Yalamarthi S. A 5-year analysis of readmissions following elective laparoscopic cholecystectomy—cohort study. Int J Surg. 2011;9(1):52–4.

    Article  CAS  PubMed  Google Scholar 

  6. Lengyel B, Azagury D, Varban O, Panizales M, Steinberg J, Brooks D, et al. Laparoscopic cholecystectomy after a quarter century: why do we still convert? Surg Endosc. 2011;26(2):508–13.

    Article  PubMed  PubMed Central  Google Scholar 

  7. Unawane A, Kamyab A, Patel M, Flynn J, Mittal V. Changing paradigms in minimally invasive surgery training. Am J Surg. 2013;205(3):284–8.

    Article  PubMed  Google Scholar 

  8. Gutt C, Encke J, Köninger J, Harnoss J, Weigand K, Kipfmüller K, et al. Acute cholecystitis. Ann Surg. 2013;258(3):385–93.

    Article  PubMed  Google Scholar 

  9. Rumack C. Diagnostic ultrasound. 5th ed. Amsterdam: Elsevier Science; 2018.

    Google Scholar 

  10. Hameed M, Sahu A, Ali H, Raje D, Sheth H. The diagnostic utility of ultrasound for acute cholecystitis. Clin Radiol. 2016;71:S27.

    Article  Google Scholar 

  11. Adams J, Barton E. Emergency medicine: clinical essentials. Amsterdam: Elsevier Health Sciences; 2013.

    Google Scholar 

  12. Woo M, Taylor M, Loubani O, Bowra J, Atkinson P. My patient has got abdominal pain: identifying biliary problems. Ultrasound. 2014;22(4):223–8.

    Article  PubMed  PubMed Central  Google Scholar 

  13. Pereira J, Afonso A, Constantino J, Matos A, Henriques C, Zago M, et al. Accuracy of ultrasound in the diagnosis of acute cholecystitis with coexistent acute pancreatitis. Eur J Trauma Emerg Surg. 2015;43(1):79–83.

    Article  PubMed  Google Scholar 

  14. Townsend C, Evers B, Mattox K, Beauchamp R. Sabiston textbook of surgery. Philadelphia: Elsevier; 2017.

    Google Scholar 

  15. Zieleskiewicz L, Muller L, Lakhal K, Meresse Z, Arbelot C, Bertrand P, et al. Point-of-care ultrasound in intensive care units: assessment of 1073 procedures in a multicentric, prospective, observational study. Intensive Care Med. 2015;41(9):1638–47.

    Article  PubMed  Google Scholar 

  16. Parks A, Atkinson P, Verheul G, LeBlanc-Duchin D. Can medical learners achieve point-of-care ultrasound competency using a high-fidelity ultrasound simulator?: a pilot study. Crit Ultrasound J. 2013;5(1):9.

    Article  PubMed  PubMed Central  Google Scholar 

  17. Blanco P, Volpicelli G. Common pitfalls in point-of-care ultrasound: a practical guide for emergency and critical care physicians. Crit Ultrasound J. 2016;8:1.

    Article  Google Scholar 

  18. Bhagra A, Tierney D, Sekiguchi H, Soni N. Point-of-Care ultrasonography for primary care physicians and general internists. Mayo Clin Proc. 2016;91(12):1811–27.

    Article  PubMed  Google Scholar 

  19. Moore C, Copel J. Point-of-care ultrasonography. N Engl J Med. 2011;364(8):749–57.

    Article  CAS  PubMed  Google Scholar 

  20. Kotagal M, Quiroga E, Ruffatto B, Adedipe A, Backlund B, Nathan R, et al. Impact of point-of-care ultrasound training on surgical residents’ confidence. J Surg Educ. 2015;72(4):e82–7.

    Article  PubMed  PubMed Central  Google Scholar 

  21. Mollenkopf M, Tait N. Is it time to include point-of-care ultrasound in general surgery training? A review to stimulate discussion. ANZ J Surg. 2013;83(12):908–11.

    Article  PubMed  Google Scholar 

  22. Yokoe M, Hata J, Takada T, Strasberg S, Asbun H, Wakabayashi G, et al. Tokyo Guidelines 2018: diagnostic criteria and severity grading of acute cholecystitis (with videos). J Hepato-Biliary-Pancreat Sci. 2018;25(1):41–54.

    Article  Google Scholar 

  23. Takada T, Strasberg S, Solomkin J, Pitt H, Gomi H, Yoshida M, et al. TG13: updated Tokyo Guidelines for the management of acute cholangitis and cholecystitis. J Hepato-Biliary-Pancreat Sci. 2013;20(1):1–7.

    Article  Google Scholar 

  24. Hirota M, Takada T, Kawarada Y, Nimura Y, Miura F, Hirata K, et al. Diagnostic criteria and severity assessment of acute cholecystitis: Tokyo guidelines. J Hepato-Biliary-Pancreat Surg. 2007;14(1):78–82.

    Article  Google Scholar 

  25. Delphi Technique. https://methods.sagepub.com/Reference/encyc-of-research-design. 2018. Accessed 3 Jan 2018.

  26. Gradepro [Internet]. Gradepro.org. 2018. https://gradepro.org/resources/. Accessed 21 Dec 2018.

  27. Herring W. Learning radiology. 3rd ed. Philadelphia: Elsevier; 2015.

    Google Scholar 

  28. Kiewiet J, Leeuwenburgh M, Bipat S, Bossuyt P, Stoker J, Boermeester M. A systematic review and meta-analysis of diagnostic performance of imaging in acute cholecystitis. Radiology. 2012;264(3):708–20.

    Article  PubMed  Google Scholar 

  29. Blaivas M, Adhikari S. Diagnostic utility of cholescintigraphy in emergency department patients with suspected acute cholecystitis: comparison with bedside RUQ ultrasonography. J Emerg Med. 2007;33(1):47–52.

    Article  PubMed  Google Scholar 

  30. Kaoutzanis C, Davies E, Leichtle S, Welch K, Winter S, Lampman R, et al. Abdominal ultrasound versus hepato-imino diacetic acid scan in diagnosing acute cholecystitis—what is the real benefit? J Surg Res. 2018;188:44–52.

    Article  Google Scholar 

  31. Klugsberger B, Haslinger-Eisterer B, Oppelt P, Shamiyeh A. Clinical value of sonography and CT-scan in the diagnosis of acute cho-lecystitis: a retrospective analysis. Ann Emerg Surg. 2017;2(4):1021.

    Google Scholar 

  32. O’Connor O, Maher M. Imaging of cholecystitis. Am J Roentgenol. 2011;196(4):W367–74.

    Article  Google Scholar 

  33. Elsayes K, Oliveira E, Narra V, EL-Merhi F, Brown J. Magnetic resonance imaging of the gallbladder: spectrum of abnormalities. Acta Radiol. 2007;48(5):476–82.

    Article  CAS  PubMed  Google Scholar 

  34. Ansaloni L, Pisano M, Coccolini F, Peitzmann A, Fingerhut A, Catena F, et al. 2016 WSES guidelines on acute calculous cholecystitis. World J Emerg Surg. 2016;11:1.

    Article  Google Scholar 

  35. Warttig S, Ward S, Rogers G. Diagnosis and management of gallstone disease: summary of NICE guidance. BMJ. 2014;349(13):g6241.

    Article  CAS  PubMed  Google Scholar 

  36. Lammert F, et al. EASL clinical practice guidelines on the prevention diagnosis and treatment of gallstones. J Hepatol. 2016;65(1):146–81.

    Article  Google Scholar 

  37. Yokoe M, Takada T, Hwang T, Endo I, Akazawa K, Miura F, et al. Descriptive review of acute cholecystitis: Japan-Taiwan collaborative epidemiological study. J Hepato-Biliary-Pancreat Sci. 2017;24(6):319–28.

    Article  Google Scholar 

  38. Cetinkunar S, Erdem H, Aktimur R, Soker G, Bozkurt H, Reyhan E, et al. Evaluation of power Doppler sonography in acute cholecystitis to predict intraoperative findings: prospective clinical study. Turkish J Trauma Emerg Surg. 2014;2014:51–6.

    Google Scholar 

  39. Soyer P, Brouland J, Boudiaf M, Kardache M, Pelage J, Panis Y, et al. Color velocity imaging and power Doppler sonography of the gallbladder wall: a new look at sonographic diagnosis of acute cholecystitis. Am J Roentgenol. 1998;171(1):183–8.

    Article  CAS  Google Scholar 

  40. Paulson E, Kliewer M, Hertzberg B, Paine S, Carroll B. Diagnosis of acute cholecystitis with color Doppler sonography: significance of arterial flow in thickened gallbladder wall. Am J Roentgenol. 1994;162(5):1105–8.

    Article  CAS  Google Scholar 

  41. Uggowitzer M, Kugler C, Schramayer G, Kammerhuber F, Gröll R, Hausegger K, et al. Sonography of acute cholecystitis: comparison of color and power Doppler sonography in detecting a hypervascularized gallbladder wall. Am J Roentgenol. 1997;168(3):707–12.

    Article  CAS  Google Scholar 

  42. Tessler F, Tublin M. Blood flow in healthy gallbladder walls on color and power Doppler sonography: effect of wall thickness and gallbladder volume. Am J Roentgenol. 1999;173(5):1247–9.

    Article  CAS  Google Scholar 

  43. Adamietz B, Wenkel E, Uder M, Meyer T, Schneider I, Dimmler A, et al. Contrast enhanced sonography of the gallbladder: a tool in the diagnosis of cholecystitis? Eur J Radiol. 2007;61(2):262–6.

    Article  PubMed  Google Scholar 

  44. Ripollés T, Martínez-Pérez M, Martin G, Vizuete J, Martínez-García R, Diez J, et al. Usefulness of contrast-enhanced US in the diagnosis of acute gangrenous cholecystitis: a comparative study with surgical and pathological findings. Eur J Radiol. 2016;85(1):31–8.

    Article  PubMed  Google Scholar 

  45. Sagrini E, Pecorelli A, Pettinari I, Cucchetti A, Stefanini F, Bolondi L, et al. Contrast-enhanced ultrasonography to diagnose complicated acute cholecystitis. Intern Emerg Med. 2015;11(1):19–30.

    Article  PubMed  Google Scholar 

  46. Kawai R, Hata J, Manabe N, Imamura H, Iida A, Nakatou R, et al. Contrast-enhanced ultrasonography with Sonazoid for diagnosis of gangrenous cholecystitis. J Med Ultrason. 2015;43(2):193–9.

    Article  Google Scholar 

  47. Martínez A, Bona X, Velasco M, Martín J. Diagnostic accuracy of ultrasound in acute cholecystitis. Gastroint Radiol. 1986;11(1):334–8.

    Article  Google Scholar 

  48. Ralls P, Colletti P, Lapin S, Chandrasoma P, Boswell W, Ngo C, et al. Real-time sonography in suspected acute cholecystitis. Prospective evaluation of primary and secondary signs. Radiology. 1985;155(3):767–71.

    Article  CAS  PubMed  Google Scholar 

  49. Bree R. Further observations on the usefulness of the sonographic Murphy sign in the evaluation of suspected acute cholecystitis. J Clin Ultrasound. 1995;23(3):169–72.

    Article  CAS  PubMed  Google Scholar 

  50. Villar J, Summers S, Menchine M, Fox J, Wang R. The absence of gallstones on point-of-care ultrasound rules out acute cholecystitis. J Emerg Med. 2015;49(4):475–80.

    Article  PubMed  Google Scholar 

  51. Stogryn S, Metcalfe J, Vergis A, Hardy K. Does ultrasongraphy predict intraoperative findings at cholecystectomy? An institutional review. Can J Surg. 2016;59(1):12–8.

    Article  PubMed  PubMed Central  Google Scholar 

  52. Sahani D, Samir A. Abdominal imaging, 2nd ed. Elsevier 2017. Chapter 56: Diffuse Gallbladder Wall Thickening; pp 609-627.

  53. Smith E, Dillman J, Elsayes K, Menias C, Bude R. Cross-sectional imaging of acute and chronic gallbladder inflammatory disease. Am J Roentgenol. 2009;192(1):188–96.

    Article  Google Scholar 

  54. Bolondi L, Gaiani S, Testa S, Labo G. Gall bladder sludge formation during prolonged fasting after gastrointestinal tract surgery. Gut. 1985;26(7):734–8.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  55. Rozycki G, Ballard R, Feliciano D, Schmidt J, Pennington S. Surgeon-performed ultrasound for the assessment of truncal injuries. Ann Surg. 1998;228(4):557–67.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  56. Brooks A. Emergency ultrasound in the acute assessment of haemothorax. Emerg Med J. 2004;21(1):44–6.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  57. Scruggs W, Fox P, Potts B, Zidenny A, McDonough J, Anderson C et al. Accuracy of ED Bedside Ultrasound for Identification of gallstones: retrospective analysis of 575 studies. West J Emerg Med [Internet]. 2008. [cited 22 December 2018];9(2):129. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2672232/.

  58. Gaspari R, Dickman E, Blehar D. Learning curve of bedside ultrasound of the gallbladder. J Emerg Med. 2009;37(1):51–6.

    Article  PubMed  Google Scholar 

  59. Kameda T, Taniguchi N. Overview of point-of-care abdominal ultrasound in emergency and critical care. J Intensive Care. 2016;4:1.

    Article  Google Scholar 

  60. Concannon E, McHugh S, Healy D, Kavanagh E, Burke P, Clarke Moloney M, et al. Diagnostic accuracy of non-radiologist performed ultrasound for abdominal aortic aneurysm: systematic review and meta-analysis. Int J Clin Pract. 2014;68(9):1122–9.

    Article  CAS  PubMed  Google Scholar 

  61. Beggs A, Thomas P. Point of use ultrasound by general surgeons: review of the literature and suggestions for future practice. Int J Surg. 2013;11(1):12–7.

    Article  PubMed  Google Scholar 

  62. Limchareon S, Jaidee W. Physician-performed focused ultrasound: an update on its role and performance. J Med Ultrasound. 2015;23(2):67–70.

    Article  Google Scholar 

  63. Arhami Dolatabadi A, Amini A, Hatamabadi H, Mohammadi P, Faghihi-Kashani S, Derakhshanfar H, et al. Comparison of the accuracy and reproducibility of focused abdominal sonography for trauma performed by emergency medicine and radiology residents. Ultrasound Med Biol. 2014;40(7):1476–82.

    Article  PubMed  Google Scholar 

  64. Cazes N, Desmots F, Geffroy Y, Renard A, Leyral J, Chaumoître K. Emergency ultrasound: a prospective study on sufficient adequate training for military doctors. Diagnost Interventional Imaging. 2013;94(11):1109–15.

    Article  CAS  Google Scholar 

  65. Summers S, Scruggs W, Menchine M, Lahham S, Anderson C, Amr O, et al. A prospective evaluation of emergency department bedside ultrasonography for the detection of acute cholecystitis. Ann Emerg Med. 2010;56(2):114–22.

    Article  PubMed  Google Scholar 

  66. Rosen C, Brown D, Chang Y, Moore C, Averill N, Arkoff L, et al. Ultrasonography by emergency physicians in patients with suspected cholecystitis. Am J Emerg Med. 2001;19(1):32–6.

    Article  CAS  PubMed  Google Scholar 

  67. Hilsden R, Leeper R, Koichopolos J, Vandelinde J, Parry N, Thompson D, et al. Point-of-care biliary ultrasound in the emergency department (BUSED): implications for surgical referral and emergency department wait times. Trauma Surg Acute Care Open. 2018;3(1):e000164.

    Article  PubMed  PubMed Central  Google Scholar 

  68. Ross M, Brown M, McLaughlin K, Atkinson P, Thompson J, Powelson S, et al. Emergency physician-performed ultrasound to diagnose cholelithiasis: a systematic review. Acad Emerg Med. 2011;18(3):227–35.

    Article  PubMed  Google Scholar 

  69. Kendall J, Shimp R. Performance and interpretation of focused right upper quadrant ultrasound by emergency physicians. J Emerg Med. 2001;21(1):7–13.

    Article  CAS  PubMed  Google Scholar 

  70. American College of Emergency Physicians [Internet]. Acep.org. 2018. https://www.acep.org/#sm.0000182s8wudfzey9vfhxife4vjwr. Accessed 22 Dec 2018.

  71. Jang T, Aubin C, Naunheim R. Minimum training for right upper quadrant ultrasonography. Am J Emerg Med. 2004;22(6):439–43.

    Article  PubMed  Google Scholar 

  72. Ćwik G, Skoczylas T, Wyroślak-Najs J, Wallner G. The value of percutaneous ultrasound in predicting conversion from laparoscopic to open cholecystectomy due to acute cholecystitis. Surg Endosc. 2013;27(7):2561–8.

    Article  PubMed  PubMed Central  Google Scholar 

  73. Siddiqui M, Rizvi S, Sartaj S, Ahmad I, Rizvi S. A standardized ultrasound scoring system for preoperative prediction of difficult laparoscopic cholecystectomy. J Med Ultrasound. 2017;25(4):227–31.

    Article  PubMed  PubMed Central  Google Scholar 

  74. Sutcliffe R, Hollyman M, Hodson J, Bonney G, Vohra R, Griffiths E, et al. Preoperative risk factors for conversion from laparoscopic to open cholecystectomy: a validated risk score derived from a prospective UK database of 8820 patients. HPB. 2016;18(11):922–8.

    Article  PubMed  PubMed Central  Google Scholar 

  75. Augustine A, Rao R, Vivek M. A comprehensive predictive scoring method for difficult laparoscopic cholecystectomy. J Minimal Access Surg. 2014;10(2):62.

    Article  Google Scholar 

  76. Bouassida M, Chtourou M, Charrada H, Zribi S, Hamzaoui L, Mighri M, et al. The severity grading of acute cholecystitis following the Tokyo Guidelines is the most powerful predictive factor for conversion from laparoscopic cholecystectomy to open cholecystectomy. J Visc Surg. 2017;154(4):239–43.

    Article  CAS  PubMed  Google Scholar 

  77. Carmody E, Arenson A, Hanna S. Failed or difficult laparoscopic cholecystectomy: can preoperative ultrasonography identify potential problems? J Clin Ultrasound. 1994;22(6):391–6.

    Article  CAS  PubMed  Google Scholar 

  78. Gurusamy K, Rossi M, Davidson B. Percutaneous cholecystostomy for high-risk surgical patients with acute calculous cholecystitis. Cochrane Datab Syst Rev. 2013;2013:8.

    Google Scholar 

  79. Mauro M, Venbrux A, Murphy K, Thomson K, Morgan R. Image-Guided Interventions: Expert Radiology Series (Expert Consult - Online and Print). 2nd ed. Elsevier Health Sciences; 2014. Chapter 137, Percutaneous Coholecystostomy; 1008-1013.

  80. Mahnken A, Wilhelm K, Ricke J. CT- and MR-guided interventions in radiology. Berlin: Springer; 2013.

    Book  Google Scholar 

  81. Mori Y, Itoi T, Baron T, Takada T, Strasberg S, Pitt H, et al. Tokyo Guidelines 2018: management strategies for gallbladder drainage in patients with acute cholecystitis (with videos). J Hepato-Biliary-Pancreat Sci. 2017;25(1):87–95.

    Article  Google Scholar 

  82. Lin W, Chang C, Chu C. Percutaneous cholecystostomy for acute cholecystitis in high-risk elderly patients. Kaohsiung J Med Sci. 2016;32(10):518–25.

    Article  PubMed  Google Scholar 

  83. Kortram K, van Ramshorst B, Bollen T, Besselink M, Gouma D, Karsten T, et al. Acute cholecystitis in high risk surgical patients: percutaneous cholecystostomy versus laparoscopic cholecystectomy (CHOCOLATE trial): Study protocol for a randomized controlled trial. Trials. 2012;13:1.

    Article  Google Scholar 

  84. Gulaya K, Desai S, Sato K. Percutaneous cholecystostomy: evidence-based current clinical practice. Semin Interventional Radiol. 2016;33(04):291–6.

    Article  Google Scholar 

  85. Granlund A, Karlson B, Elvin A, Rasmussen I. Ultrasound-guided percutaneous cholecystostomy in high-risk surgical patients. Langenbeck’s Arch Surg. 2001;386(3):212–7.

    Article  CAS  Google Scholar 

  86. Vilaverde F, Sousa M, Mesquita R, Pinto J, Reis A. US-GUIDED Cholecystectomy: a retrospective study of indications, complications and outcome. Acta Radiol Portuguesa. 2015;27(104):17–20.

    Google Scholar 

  87. Eggermont A. Ultrasound-Guided percutaneous transhepatic cholecystostomy for acute acalculous cholecystitis. Arch Surg. 1985;120(12):1354.

    Article  CAS  PubMed  Google Scholar 

  88. Requarth J. Ultrasound-guided percutaneous cholecystostomy in pregnancy. J Am Coll Surg. 2010;211(1):145.

    Article  PubMed  Google Scholar 

  89. Allmendinger N, Hallisey M, Ohki S, Johnstraub J. Percutaneous cholecystostomy treatment of acute cholecystitis in pregnancy. Obstet Gynecol. 1995;86(4):653–4.

    Article  CAS  PubMed  Google Scholar 

  90. Dewhurst C, Kane R, Mhuircheartaigh J, Brook O, Sun M, Siewert B. Complication rate of ultrasound-guided percutaneous cholecystostomy in patients with coagulopathy. Am J Roentgenol. 2012;199(6):W753–60.

    Article  Google Scholar 

  91. Başaran O, Yavuzer N, Selçuk H, Harman A, Karakayali H, Bilgin N. Ultrasound-guided percutaneous cholecystostomy for acute cholecystitis in critically ill patients: one center’s experience. Turk J Gastroenterol. 2005;3(16):134–7.

    Google Scholar 

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Authors and Affiliations

  1. Division of Hepatobiliary Surgery, Department of General Surgery, Hospital São Teotónio, Viseu, Portugal

    Jorge Pereira

  2. Department of Surgery, Tallaght University Hospital, Dublin 24, Ireland

    Gary A. Bass

  3. Royal College of Surgeons in Ireland, 123 St Stephens Green, Dublin 2, Ireland

    Gary A. Bass & Bogdan D. Dumbrava

  4. Department of Emergency General Surgery, Legnano Hospital, ASST Ovest Milanese, Legnano, MI, Italy

    Diego Mariani

  5. Department of Emergency Medicine, Ospedale “S. Maria delle Stelle”, ASST Melegnano e Martesana, Melzo, MI, Italy

    Andrea Casamassima

  6. Division of Colorectal Surgery, Department of General Surgery, Pedro Hispano Hospital, Matosinhos, Portugal

    António Rodrigues da Silva

  7. Division of Esophagogastric Surgery, Department of General Surgery, Hospital São Teotónio, Viseu, Portugal

    Luis Pinheiro

  8. Department of General Surgery, Hospital Médico-Quirúrgico, Jaén, Spain

    Isidro Martinez-Casas

  9. Division of Minimally Invasive Surgery and Surgical Oncology, Department of Surgery, Policlinico San Pietro, Ponte San Pietro, Bergamo, Italy

    Mauro Zago

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Consensus Conference: European Congress for Trauma & Emergency Surgery, Palais de Congressos, Valencia, Spain, 6th May 2018.

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Pereira, J., Bass, G.A., Mariani, D. et al. Surgeon-performed point-of-care ultrasound for acute cholecystitis: indications and limitations: a European Society for Trauma and Emergency Surgery (ESTES) consensus statement. Eur J Trauma Emerg Surg 46, 173–183 (2020). https://doi.org/10.1007/s00068-019-01197-z

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