Ultrasound-guided percutaneous cholecystostomy in acute cholecystitis: case vignette and review of the technique
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Acute cholecystitis is a frequent condition. Although cholecystectomy is the indicated treatment of this entity, it cannot be performed in some high-risk surgery patients, such as critically ill or those with multiple comorbidities. In these non-uncommon scenarios, percutaneous cholecystostomy is the recommended alternative treatment, which allows immediate decompression and drainage of the acutely inflamed gallbladder and thus reducing the patient’s symptoms and the systemic inflammatory response. Ultrasound is the imaging method of choice to guide the percutaneous cholecystostomy procedure due to its real-time guidance, lack of ionizing radiation and portability, avoiding the need to transfer unhealthy patients to the radiology department. We will review the ultrasound-guided percutaneous cholecystostomy procedure, of special interest for radiologists, surgeons, and also intensive care and emergency physicians.
KeywordsAcute cholecystitis Interventional radiology Ultrasonography Cholecystostomy
La colecistiti acuta é una malattia frequente. Benché la colecistectomia laparotomica sia una procedura validata essa non è idonea nella popolazione ad alto rischio, quali i pazienti critici o quelli con elevate comorbiditá. In tali categorie il trattamento percutaneo é la procedura suggerita consentendo di decomprimere la colecisti e ridurre i sintomi sirs correlati. La metodica eco assistita real time e la procedura di scelta in considerazione della assenza di radiazioni e la facilita´di esecuzione in ambiti extra radiologici. Descriveremo di seguito la tecnica di colecistostomia eco guidata di interesse radiologico, chirurgico e rianimatorio.
The authors would like to thank Mrs. Celeste Bruno for the language guidance and Dr. Diego Atzeni (P.O. Marino, Cagliari, Italy) for his valuable help in editing the Italian version of the abstract. This work has not been supported by any grants.
Conflict of interest
Authors have no conflicts of interest related to this submission.
All human and animal studies have been approved by the appropriate ethics committee and have therefore been performed in accordance with the ethical standards laid down in Helsinski Declaration of 1975 and its late amendments.
Written informed consent was obtained from the patient for the publication of this case report and accompanying images.
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