대한소화기학회로고
 
 
 
Author Byung Hyo Cha*, Ha Hun Song1, Young Nam Kim, Won Jung Jeon, Sang Jin Lee, Jin Dong Kim, Hak Hyun Lee, Ban Seok Lee and Sang Hyub Lee2*
Place of duty Digestive Disease Center, Department of Internal Medicine, Department of Radiology1, Cheju Halla General Hospital, Jeju, Department of Internal Medicine, Liver Research Institute, Seoul National University College of Medicine, Seoul2, Korea
Title Percutaneous Cholecystostomy Is Appropriate as Definitive Treatment for Acute Cholecystitis in Critically Ill Patients: A Single Center, Cross-sectional Study
Publicationinfo The Korean Journal of Gastroenterology 2014 Jan; 063(01): 32-38.
Key_word Acute cholecystitis; Cholecystectomy; Comorbidity; Cholecystostomy; Elderly
Full-Text
This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.
Abstract Background/Aims: Percutaneous cholecystostomy (PC) is an effective treatment for cholecystitis in high-risk surgical patients. However, there is no definitive agreement on the need for additional cholecystectomy in these patients. Methods: All patients who were admitted to Cheju Halla General Hospital (Jeju, Korea) for acute cholecystitis and who underwent ultrasonography-guided PC between 2007 and 2012 were consecutively enrolled in this study. Among 82 total patients enrolled, 35 underwent laparoscopic cholecystectomy after recovery and 47 received the best supportive care (BSC) without additional surgery. Results: The technical and clinical success rates for PC were 100% and 97.5%, respectively. The overall mean survival was 12.8 months. In the BSC group, mean survival was 5.4 months, and in the cholecystectomy group, mean survival was 22.4 months (p<0.01). However, there was no significant difference between these groups in multivariate analysis (relative risk [RR]=1.92; 95% CI, 0.77-4.77; p=0.16). However, advanced age (RR=1.05; 95% CI, 1.02-1.08; p=0.001) and higher class in the American Society of Anesthesiologists’ physical status (RR=3.06; 95% CI, 1.37-6.83, p=0.006) were significantly associated with survival in the multivariate analysis. Among the 47 patients in the BSC group, the cholecystostomy tube was removed in 31 patients per protocol. Recurrent cholecystitis was not observed in either group of patients during the follow-up period. Conclusions: In high-risk surgical patients, PC without additional cholecystectomy might be the best definitive management. Furthermore, the cholecystostomy drainage catheter can be safely removed in certain patients. (Korean J Gastroenterol 2014;63:32-38)
저 자 차병효*, 송하헌1, 김영남, 전원중, 이상진, 김진동, 이학현, 이반석, 이상협2*
소 속 제주한라병원 내과 소화기병센터, 방사선학과1, 서울대학교 의과대학 내과학교실 간연구소2
제 목 수술 고위험 중증 환자에게서 발생한 급성 담낭염의 경피적 담낭배액술 단독 치료와 담낭절제술 비교: 단일 기관, 단면 연구
출판정보 Korean J Gastroenterol 2014 Jan; 063(01): 32-38.
Copyright©2008 The Korean Society of Gastroenterlogy. All Rights Reserved.
Room 305, 31 Seolleung-ro 86 gil, Gangnam-gu, Seoul, 135-839, Korea
TEL:+82-2-538-0627 | FAX:+82-2-538-0635 | E-MAIL:gastrokorea@kams.or.kr