Tıp Fakültesi / Faculty of Medicine

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Subject: search.filters.subject.Cholecystostomy

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    Long-Term Results of Percutaneous Cholecystostomy for Definitive Treatment of Acute Acalculous Cholecystitis : A 10-Year Single-Center Experience
    (2018) Ozyer, U.; 0000-0002-4300-009X; 30350527; AAK-9071-2021
    Background and study aims : Conventional use of percutaneous cholecystostomy [PC] is bridging therapy todelayed cholecystectomy for acute cholecystitis in high-surgical risk patients. Primary aim of this report is to evaluate the long-term outcome of PC as a definitive treatment for acute acalculous cholecystitis [AAC]. Patients and methods : Seventy-one AAC patients who underwent PC procedure were identified. Fifty-one interventions in 47 patients who were treated only with PC and followed-up after catheter withdrawal were reviewed to evaluate the long-term efficacy of PC as a definitive treatment for AAC. Results : Technical and short-term clinical success rates were 100% ) and 92%, respectively. In-hospital mortality rate was 9.3%, minor complication rate was 5.3%, major complication rate was 2.7% and procedure related mortality was 0%. Median follow-up after catheter withdrawal was 8 months. Long-term primary clinical success after removal of the catheter was 87.2%. With the repeated PC in 4 of 6 recurrences, clinical success was 95.7%. Presence of bile sludge, perforation or a co-existing disease did not result in a significant difference in recurrence free survival. Conclusions : PC was a safe and easy to perform procedure with high positive clinical response and low long-term recurrence rate. PC without subsequent cholecystectomy may be a favorable treatment for AAC with respect to high surgical risk present in most of the AAC patients.
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    Treatment with ultrasound guided percutaneous cholecystostomy in acute cholecystitis: 10-year a single-center experience
    (2017) Ozyer, Umut; Yildirim, Muge; Yildirim, Utku Mahir; 0000-0002-4300-009X; AAK-9071-2021; AAK-9071-2021
    Purpose: Evaluating the technical success, clinical outcomes and safety of ultrasound-guided percutaneous cholecystostomy (PC) in patients with acute cholecystitis. Material and Methods: Medical records of patients diagnosed as acute cholecystitis and treated with PC from year 2000 to 2011 were retrospectively examined. ASA scores, leukocyte counts, gall stone presence, bile cultures, additional interventions, interval surgery, procedure-related complications and mortality were reviewed. Results: PC catheters were placed in 127 patients (72 male, 55 female) aged from 31 to 100 years. Technical success of the procedure was 100%. Clinical success was obtained in 86% of the patients. No procedure related mortality or early major complications were observed. Minor complication rate was 7% (9/127) and late major complication rate was 3% (4/127). Thirty day in-hospital mortality rate was 8% (10/127). Six patients died after interval cholecystectomy and 4 patients died before the operation. PC served as a definitive treatment in 74% (17/23) of the patients with acalculous cholecystitis. Fifty-eight percent (31/53) of the patients with acute calculous cholecystitis were treated only with percutaneous cholecystostomy and only 10% (3/31) had recurrent cholecystitis in follow up. Conclusion: PC can be preferred over primary cholecystectomy in acute cholecystitis patients. The procedure has high technical success, high clinical response and low complication rates. It can also serve as a definitive treatment option in patients with high surgical risk.