Outcomes of percutaneous cholecystostomy and predictors of subsequent cholecystectomy

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Cooper, S
Donovan, M
Grieve, DA
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2017
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Abstract

Background: The use of a percutaneous cholecystostomy (PC) in the management of severe acute cholecystitis is a well recognized alternative to acute cholecystectomy. The need for definitive surgical management remains controversial. Methods: A retrospective analysis of hospital records at Nambour General Hospital between 2012 and 2016 was conducted and data relating to indications, demographics, comorbidities and outcomes were collected. Results: Thirty PC patients (20 male and 10 female) were identified, with a mean age of 77 years (range 46–93). Thirteen proceeded to cholecystectomy, nine elective and four emergent. Mean time to operation was 97 days (range 1–480). Ten were performed laparoscopically with a complication rate of 23% (3/13). One patient in the operative group died. Seventeen patients did not proceed to cholecystectomy. Fifteen resolved and were discharged, and two died. Three of those discharged were readmitted with gallstone disease requiring treatment, one of which died. A total of 71% (12/17) of the non-operative group died and three of those had a cause of death related to gallstone disease. The operative group was younger (P = 0.01) and had a lower estimated mortality risk (P < 0.05). In this cohort, this translated to an overall survival benefit (P < 0.01). Conclusion: Predictors of eventual cholecystectomy include younger age and lower estimated mortality risk. Patients who require a PC for the treatment of acute cholecystitis and subsequently go on to cholecystectomy can expect to have a favourable outcome.

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ANZ Journal of Surgery

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88

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7-Aug

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© 2017 Royal Australasian College of Surgeons. This is the peer reviewed version of the following article: Outcomes of percutaneous cholecystostomy and predictors of subsequent cholecystectomy, ANZ Journal of Surgery, 88 (7-8), pp. E598-E601, 2017, which has been published in final form at https://doi.org/10.1111/ans.14251. This article may be used for non-commercial purposes in accordance with Wiley Terms and Conditions for Use of Self-Archived Versions. This article may not be enhanced, enriched or otherwise transformed into a derivative work, without express permission from Wiley or by statutory rights under applicable legislation. Copyright notices must not be removed, obscured or modified. The article must be linked to Wiley’s version of record on Wiley Online Library and any embedding, framing or otherwise making available the article or pages thereof by third parties from platforms, services and websites other than Wiley Online Library must be prohibited.

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Subject

Clinical sciences

Dentistry

cholecystectomy

cholecystitis

cholecystostomy

outcome

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Cooper, S; Donovan, M; Grieve, DA, Outcomes of percutaneous cholecystostomy and predictors of subsequent cholecystectomy, ANZ Journal of Surgery, 2017, 88 (7-8), pp. E598-E601

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