Safety and usefulness of percutaneous transhepatic cholecystoscopy examination in high-risk surgical patients with acute cholecystitis.

Abstract:

BACKGROUND:The aim of the present study was to evaluate the diagnostic and therapeutic usefulness of percutaneous transhepatic cholecystoscopy in high-risk surgical patients with acute cholecystitis. METHODS:Between January 1992 and June 1998, there were 33 consecutive patients who underwent percutaneous transhepatic cholecystostomy and subsequent percutaneous transhepatic cholecystoscopy for the management of acute cholecystitis. RESULTS:Percutaneous transhepatic cholecystostomy and subsequent percutaneous transhepatic cholecystoscopy were successfully accomplished in all 33 patients. During percutaneous transhepatic cholecystoscopy, minor complications (2 episodes of minor bleeding during electrohydraulic lithotripsy, 2 of tube dislodgement, and 1 of bile leakage to peritoneum) occurred in 5 patients. Percutaneous transhepatic cholecystoscopy revealed gallstones in 26 cases, sludge ball in 3, gallbladder carcinoma in 3, and 1 case of clonorchiasis related with acute cholecystitis. The 3 gallbladder cancers which were not identified radiologically were found incidentally during percutaneous transhepatic cholecystoscopy. For the 26 patients with gallstones, percutaneous transhepatic cholecystoscopy and concomitant stone removal were successful in 1 to 4 consecutive sessions (mean 2.2 sessions). Gallstones recurred in 3 of 22 patients (14%) during the mean follow-up period of 27 months. All of them remain asymptomatic. CONCLUSION:Percutaneous transhepatic cholecystostomy may be justified in the management of acute cholecystitis in selected patients with high surgical risk.

journal_name

Gastrointest Endosc

authors

Kim HJ,Lee SK,Kim MH,Yoo KS,Lim BC,Seo DW,Min YI

doi

10.1067/mge.2000.107286

keywords:

subject

Has Abstract

pub_date

2000-11-01 00:00:00

pages

645-9

issue

5

eissn

0016-5107

issn

1097-6779

pii

S0016-5107(00)55631-4

journal_volume

52

pub_type

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