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Percutaneous cholecystostomy as a bridge therapy in the geriatric age group with acute cholecystitis

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Abstract

Objective

The aim of this study was to investigate the efficacy of percutaneous cholecystostomy (PC) in the geriatric patients with acute cholecystitis.

Materials and methods

The records of geriatric patients with high surgical risk who underwent percutaneous cholecystostomy for acute cholecystitis were reviewed retrospectively.

Results

The median age of 134 patients who underwent percutaneous cholecystostomy was 77 (65–98) years and 63.4% were women. The mean length of hospital stay was 5 (4–18) days, and the follow-up period until the procedure was 2 (1–6) days. Murphy’s sign was positive in 79.1% of patients on physical examination, and the remaining patients (20.9%) had only tenderness on examination. As USG findings, 59.0% of the patients had a gall bladder wall thickness (> 4 mm) with pericholecystic fluid. Additional imaging method, abdominal CT, was performed in 29 patients (21.6%), MRCP was performed in three patients (2.2%), and ERCP was performed in one patient (0.7%). Bacterial growth was detected in 27.6% of the bile cultures performed. During the follow-up period, laparoscopic cholecystectomy was performed in 60.4% of the patients and open cholecystectomy was performed in 5.2% of the patients electively. 34.3% of the patients did not undergo any surgery. Bile leakage was detected in two patients (1.5%) as a procedure-related complication, and no mortality was observed.

Conclusion

Abdominal ultrasonography-guided PC is a safe and effective method in the management of acute cholecystitis in high-risk patients in the geriatric age group.

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Acknowledgements

We would like to thank Dr Onur Ergün for his support in the design and data of the article.

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Authors and Affiliations

  1. General Surgery Clinic, Ankara Etlik City Hospital, Ankara, 06500, Turkey

    Harun Karabacak

  2. Department of General Surgery and Transplantation, Başkent University, Ankara, Turkey

    Şener Balas

Authors
  1. Harun Karabacak
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  2. Şener Balas
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Correspondence to Harun Karabacak.

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Karabacak, H., Balas, Ş. Percutaneous cholecystostomy as a bridge therapy in the geriatric age group with acute cholecystitis. Ir J Med Sci (2023). https://doi.org/10.1007/s11845-023-03550-z

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