Percutaneous Cholecystostomy in High Risk Patients with Acute Cholecystitis
Percutaneous Cholecystostomy in High Risk Patients with Acute Cholecystitis作者机构：Department of General Surgery Government Medical College Srinagar India
出 版 物：《Surgical Science》 (外科学（英文）)
年 卷 期：2017年第8卷第3期
页 面：154-161页
学科分类：1002[医学-临床医学] 100214[医学-肿瘤学] 10[医学]
主 题：Percutaneous Cholecystostomy Cholecystitis Ultrasound High Risk Cholecystogram
摘 要：Aims and Objectives: To assess efficacy and safety of percutaneous cholecystostomy (PC) in high risk patients with acute cholecystitis. Materials and Methods: The study was carried out in high risk patients with acute calculous or acalculous cholecystitis. Patients qualifying for the study were subjected to PC under ultrasound (USG) guidance. A cholecystogram was done postoperatively, to help establish satisfactory catheter position. Results: 24 (70.59%) patients had empyema-gallbladder, 8 (23.53%) had acute calcular cholecystitis and 2 (5.9%) patients were diagnosed as acalcular cholecystitis. None of the patients was fit for general anesthesia at the time of admission. Median hospital-stay after performing procedure was 4 days. Clinical success rate was reported 100% in our study. Bile cultures yielded growth of E Coli in 10 (29.41%), klebsela in 8 (23.53%), pseudomonas aeruginosa in 6 (17.65%) and Proteus mirabilis in 4 (11.8%) of patients. 6 (17.65%) patients did not grow any organism in their bile. Growth noted was sensitive to imipenem 29.41% (10), ciprofloxacin 17.65% (6), levofloxacin 17.65% % (6) and cefuroxime 11.76% (4). No major complication was recorded in our study. No procedure related death was observed. Tube displacement occurred in one patient and minor bleeding was reported in 2 patients. Catheter was removed after a mean of 25.25 days. All patients underwent definitive surgical intervention during the follow up period of 3 months. Conclusion: USG guided PC is a safe and effective procedure for treating high-risk patients who present with acute cholecystitis. Once the acute symptoms diminish or resolve, it should be followed by elective surgery.
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