Advertisement

Gastrointestinal Radiology

, Volume 16, Issue 1, pp 154–156 | Cite as

Percutaneous cholecystostomy in critically Ill patients

  • Steven K. Teplick
  • David L. Harshfield
  • Jeffrey C. Brandon
  • John R. BroadwaterJr.
  • John B. Cone
Article

Abstract

Sixteen critically ill patients underwent percutaneous cholecystostomy because of suspected acute cholecystitis. The procedure was technically successful, although 11 of 16 patients died subsequently because of various complications of their underlying primary disorders. We reviewed this series to reassess the value of percutaneous cholecystostomy. Four of 11 patients with definite acute cholecystitis (group 1) were cured by this technique, but three required surgery because of gallbladder wall necrosis. Two of these were among four cases which had demonstrated pericholecystic fluid collections on computed tomography (CT) or ultrasound of the abdomen. There were also five patients (group 2) in whom acute cholecystitis or its relationship to patients' symptoms were not fully determined, and four of them did not improve after percutaneous cholecystostomy. We conclude that this technique has a lower success rate in critically ill patients than reported previously.

Key words

Gallbladder, interventional techniques Cholecystitis, diagnosis Percutaneous cholecystostomy, complications 

Preview

Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.

References

  1. 1.
    McGahan JP, Lindfors KK. Percutaneous cholecystostomy: an alternative to surgical cholecystostomy for acute cholecystitis?Radiology 1989; 173:481–485PubMedGoogle Scholar
  2. 2.
    Lohella P, Soiva M, Suramo I, Taavitsainer M, Holopainen O. Ultrasonic guidance for percutaneous puncture and drainage in acute cholecystitis.Acta Radiol Diag 1986; 27:543–546Google Scholar
  3. 3.
    Pearse DM, Hawkins IF, Shaver R, Vogel S. Percutaneous cholecystostomy in acute cholecystitis and common duct obstruction.Radiology 1984; 152:365–367PubMedGoogle Scholar
  4. 4.
    Klimberg S, Hawkins I, Vogel SB. Percutaneous cholecystostomy for acute cholecystitis in high-risk patients.Am J Surg 1987; 153:125–129PubMedGoogle Scholar
  5. 5.
    Larssen TB, Gothlin JH, Jensen D, Arnesjo B, Soriede O. Ultrasonically and fluoroscopically guided therapeutic percutaneous catheter drainage of the gallbladder.Gastrointest Radiol 1988; 13:37–40PubMedGoogle Scholar
  6. 6.
    Eggermont AM, Lameris JS, Jeekel J. Ultrasound-guided percutaneous transhepatic cholecystostomy for acute acalculous cholecystitis.Arch Surg 1985; 120:1354–1356PubMedGoogle Scholar
  7. 7.
    Makucchi M, Yamazaki S, Hasegawa H. Ultrasonically guided cholangiography and bile drainage.Ultrasound Med biol 1984; 10:617–623PubMedGoogle Scholar
  8. 8.
    van Sonnenberg E, Wittich GR, Casola G, et al. Diagnostic and therapeutic percutaneous gallbladder procedures.Radiology 1986; 160:23–26PubMedGoogle Scholar
  9. 9.
    Jurkovich GJ, Dyess DL, Ferrara JJ. Cholecystostomy: expected outcome in primary and secondary biliary disorders.Am Surg 1988; 54:40–44PubMedGoogle Scholar
  10. 10.
    Smith R, Rosen JM, Gallo LN, Alderson PO. Pericholecystic hepatic activity in cholescintigraphy.Radiology 1985; 156:797–800PubMedGoogle Scholar
  11. 11.
    Vogelzang RL, Nemcek HA Jr. Percutaneous cholecystostomy: diagnostic and therapeutic efficacy.Radiology 1988; 168:29–34PubMedGoogle Scholar

Copyright information

© Springer-Verlag New York Inc. 1991

Authors and Affiliations

  • Steven K. Teplick
    • 1
  • David L. Harshfield
    • 1
  • Jeffrey C. Brandon
    • 3
  • John R. BroadwaterJr.
    • 2
  • John B. Cone
    • 2
  1. 1.Department of RadiologyUniversity of Arkansas for Medical SciencesLittle RockUSA
  2. 2.Department of SurgeryUniversity of Arkansas for Medical SciencesLittle RockUSA
  3. 3.Department of RadiologyUniversity of California at IrvineOrangeUSA

Personalised recommendations