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Percutaneous cholecystostomy: who responds?
R E England1, V G McDermott, T P Smith
1Department of Diagnostic Radiology, Duke University Medical Center, Durham, NC 27710, USA.
AJR. American Journal of Roentgenology
|May 1, 1997
Summary
Predicting response to percutaneous cholecystostomy for acute cholecystitis is possible. Clinical signs, gallstones, and pericholecystic fluid indicate a positive outcome for this gallbladder treatment.
Area of Science:
- Gastroenterology
- Interventional Radiology
- Abdominal Imaging
Background:
- Acute cholecystitis is a common surgical emergency.
- Percutaneous cholecystostomy offers a less invasive treatment option.
- Identifying predictors of treatment success is crucial for patient management.
Purpose of the Study:
- To identify clinical and radiologic features predicting response to percutaneous cholecystostomy.
- To improve patient selection and treatment outcomes for acute cholecystitis.
Main Methods:
- Retrospective review of clinical records and radiologic images (1987-1994).
- Defined response as clinical improvement or normalization of fever and WBC within 72 hours.
- Analyzed gallstones, gallbladder wall thickening, distention, and pericholecystic fluid for predictive value.
Main Results:
- 73% of patients responded to percutaneous cholecystostomy.
- Gallstones and localized right upper quadrant symptoms predicted response (p = .006).
- Pericholecystic fluid in patients with gallstones was a key radiologic predictor (p = .03).
Conclusions:
- Clinical presentation and specific radiologic findings predict percutaneous cholecystostomy success.
- Presence of pericholecystic fluid in gallstone patients is a significant indicator.
- An increasing number of radiologic findings correlate with positive treatment response.