Document Detail


Percutaneous cholecystostomy as the sole treatment in critically ill and elderly patients.
MedLine Citation:
PMID:  22327921     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
PURPOSE: This study was done to investigate the effectiveness and clinical outcome of percutaneous cholecystostomy (PC) of treating acute cholecystitis in critical ill and elderly patients. MATERIALS AND METHODS: In the last 3 years, PC was performed on 30 elderly and critically ill patients (17 men, 13 women; mean age 78.6, range 57-97 years) with acute cholecystitis and comorbid diseases. RESULTS: Technical success was 30/30 (100%). Clinical effectiveness was 30/30 (100%), with statistically significant reductions in while blood cell (WBC) count, C-reactive protein (CRP) and fever. Mean WBC upon admission (19.87×10(3)±1.61×10(3) /μl), axillary temperature (38.2±0.11 °C), and CRP (248.7±4.76 mg/l) values were significantly decreased in the 72 h following PC [12.9×10(3) ± 1.05×10(3)/μl (p≤0.0001), 37 ± 0.04 °C (p≤0.0001), 113.5 ± 3 mg/l (p≤0.0001), respectively]. Clinical and ultrasonographic (US) signs of acute cholecystitis decreased in all patients. There were no major complications or procedure-related deaths, and the morbidity rate was low (3/30; 10%). CONCLUSIONS: PC appears to be a fast, easy and effective treatment for the acute phase of cholecystitis in elderly and critically ill patients. Procedure-related morbidity and mortality rates are very low compared with surgery. Conservative treatment for patients who are not eligible for surgery is acceptable.
Authors:
G Carrafiello; A D'Ambrosio; M Mangini; M Petullà; G L Dionigi; A M Ierardi; F Piacentino; F Fontana; C Fugazzola
Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2012-2-10
Journal Detail:
Title:  La Radiologia medica     Volume:  -     ISSN:  1826-6983     ISO Abbreviation:  -     Publication Date:  2012 Feb 
Date Detail:
Created Date:  2012-2-13     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0177625     Medline TA:  Radiol Med     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Affiliation:
Department of Radiology, Università dell'Insubria, Viale Borri 57, 21100, Varese, Italy, g.carraf@tin.it.
Vernacular Title:
La colecistostomia percutanea come unico trattamento nei malati critici e nei pazienti anziani.
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