Percutaneous cholecystostomy for severe (Tokyo 2013 stage III) acute cholecystitis.
Purposes: To evaluate the impact of percutaneous cholecystostomy (PC) on severe acute cholecystitis (AC). Methods: According to the ICD-9 classification, we retrospectively retrieved medical records of patients discharged with a diagnosis of AC from January 2007 to December 2016 at our hospital. Pat...
| Publicado en: | European Journal of Trauma & Emergency Surgery Vol. 45; no. 2; pp. 329 - 337 |
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| Autores principales: | , , , |
| Formato: | research tables/charts Journal Article |
| Publicado: |
Springer Nature
Apr2019
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| Acceso en línea: | Ver este registro en EBSCOhost |
| fields | @attributes: recordID: 1 pdfLink: plink: https://search.ebscohost.com/login.aspx?direct=true&db=ccm&AN=135779026&site=ehost-live header: @attributes: shortDbName: ccm uiTerm: 135779026 longDbName: CINAHL Complete uiTag: AN controlInfo: bkinfo: dissinfo: jinfo: jid: 18639933 3C05 jtl: European Journal of Trauma & Emergency Surgery issn: 18639933 maglogo: N pubinfo: dt: Apr2019 vid: 45 iid: 2 pid: 237 pub: Springer Nature place: New York, New York artinfo: ui: 135779026 135779026 135779026 10.1007/s00068-018-0912-0 135779026 ppf: 329 ppct: 8 formats: fmt: – @attributes: type: T – @attributes: type: P tig: atl: Percutaneous cholecystostomy for severe (Tokyo 2013 stage III) acute cholecystitis. aug: au: Polistina, F. Mazzucco, C. Coco, D. Frego, M. affil: Department of General Surgery, Monselice Hospital, Via Albere, 1, 35043, Monselice, Padua, Italy sug: subj: Cholecystitis Surgery Cholecystectomy Methods Severity of Illness Evaluation International Classification of Diseases Treatment Outcomes Evaluation Human Retrospective Design Medical Records Cholecystitis Diagnosis Stratified Random Sample Severity of Illness Indices Patient Preference Treatment Failure Mortality Morbidity Ascites Scales Data Analysis Descriptive Statistics ab: Purposes: To evaluate the impact of percutaneous cholecystostomy (PC) on severe acute cholecystitis (AC). Methods: According to the ICD-9 classification, we retrospectively retrieved medical records of patients discharged with a diagnosis of AC from January 2007 to December 2016 at our hospital. Patients were then stratified according to the Tokyo 2013 (TG 13) AC severity criteria. Grade III AC was diagnosed according to the TG 13 criteria. Indications for PC were failure of optimal medical treatment within 48 h, worsening of clinical condition within early medical treatment, patients unfit for upfront surgery and patient's preference. Ascites was considered a contraindication to PC while coagulopathy was considered a minor contraindication. Primary end points were: clinical improvement, morbidity and related mortality. Secondary endpoints were AC recurrences and elective laparoscopic cholecystectomies (LS). Response was evaluated by clinical and blood test improvement. Morbidity was evaluated according to the Dindo–Clavien scale. Results: A total of 117 eligible patients were diagnosed as grade III AC. Of these, 29 (24.7%) underwent PC. The procedure was completed in all cases. Overall morbidity rate was 20.6%. Main complication was the drainage dislodgement due to involuntary patient's movement. Overall mortality was 17.2% but no causes of death were dependent upon the procedure. Clinical improvement was reported in 95.5% of surviving patients. Conclusion: This study confirms that PC is a valuable tool in the treatment of severe AC. Randomized trials are needed to clarify the criteria for patient selection and to optimize the timing for both cholecystostomy and cholecystectomy. pubtype: Academic Journal doctype: research tables/charts Journal Article ougenre: Article language: English refInfo: holdings: @attributes: islocal: N |
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