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[Acute cholecystitis: percutaneous transhepatic drainage]
H Berger1, T Hilbertz, H Forst
1Radiologische Klinik und Poliklinik, Klinikum Grosshadern, München.
Insights
Percutaneous cholecystostomy can be a definitive treatment for acute cholecystitis in select patients, avoiding the need for surgery. Long-term observation showed normal gallbladder function in patients treated solely with drainage.
Area of Science:
- Gastroenterology
- Interventional Radiology
- Surgical Innovation
Context:
- Acute cholecystitis management
- Gallbladder disease treatment
- Surgical risk assessment
Purpose:
- Evaluate percutaneous cholecystostomy as a definitive treatment for acute cholecystitis
- Assess long-term gallbladder function after percutaneous drainage
- Identify patient selection criteria for non-operative management of acute cholecystitis
Summary:
- Operative cholecystectomy remains the standard for acute cholecystitis.
- Percutaneous cholecystostomy offers an alternative for high-risk surgical candidates.
- In 19/36 patients, percutaneous drainage was definitive; long-term ultrasound showed normal gallbladder function.
Impact:
- Percutaneous drainage may obviate the need for cholecystectomy in selected acute cholecystitis cases.
- This approach can improve outcomes for patients unfit for surgery.
- Supports minimally invasive techniques in gallbladder disease management.
Abstract:
Despite emerging endoscopic techniques for treatment of gallbladder diseases the operative cholecystectomy is the treatment of choice in acute cholecystitis. Percutaneous cholecystostomy is an alternative treatment modality in poor surgical risk patients. In 19 out of 36 patients with percutaneous cholecystostomy no subsequent cholecystectomy was performed. A long-term observation of these 19 patients showed normal function of the gallbladder in ultrasound studies, thus percutaneous drainage can be a definitive treatment for acute cholecystitis in selected cases.