Korean J Gastroenterol.  2015 Oct;66(4):209-214. 10.4166/kjg.2015.66.4.209.

Timing of Cholecystectomy after Percutaneous Cholecystostomy for Acute Cholecystitis

• Jung W
• Park DE

• KMID: 2373343
• DOI: http://doi.org/10.4166/kjg.2015.66.4.209

Abstract

BACKGROUND/AIMS
Laparoscopic cholecystectomy is the standard treatment for acute cholecystitis. Percutaneous cholecystostomy is an alternative treatment to resolve acute inflammation in patients with severe comorbidities. The purpose of this study is to determine the optimal timing of laparoscopic cholecystectomy after percutaneous cholecystostomy for the patients with acute cholecystitis.
METHODS
This retrospective study was conducted in patients who underwent cholecystectomy after percutaneous cholecystostomy from January 2010 through November 2014. Seventy-four patients were included in this study. The patients were divided into two groups by the operation timing. Group I patients underwent cholecystectomy within 10 days after percutaneous cholecystostomy (n=30) and group II patients underwent cholecystectomy at more than 10 days after percutaneous cholecystostomy (n=44).
RESULTS
There was no significant difference between groups in conversion rate to open surgery, operation time, perioperative complications rate, and days of hospital stay after operation. However, complications related to cholecystostomy such as catheter dislodgement occurred significantly more often in group II than group I (group I:group II=0%:18.2%; p=0.013).
CONCLUSIONS
Timing of laparoscopic cholecystectomy after percutaneous cholecystostomy did not influence postoperative outcomes. However, late surgery caused more complications related to cholecystostomy than early surgery. Therefore, early laparoscopic cholecystectomy should be considered over late surgery after percutaneous cholecystostomy insertion.

Keyword

Acute cholecystitis; Laparoscopic cholecystectomy; Cholecystostomy

MeSH Terms

Aged
Aged, 80 and over
Cholecystectomy, Laparoscopic/adverse effects
Cholecystitis, Acute/*diagnosis/surgery
Cholecystostomy
Female
Humans
Length of Stay
Male
Middle Aged
Postoperative Complications
Retrospective Studies

Reference

References

1. Mouret P. From the first laparoscopic cholecystectomy to the frontiers of laparoscopic surgery: the future prospectives. Dig Surg. 1991; 8:124–125.

2. Yamashita Y, Takada T, Hirata K. A survey of the timing and approach to the surgical management of patients with acute cholecystitis in Japanese hospitals. J Hepatobiliary Pancreat Surg. 2006; 13:409–415.

3. Zucker KA, Flowers JL, Bailey RW, Graham SM, Buell J, Imbembo AL. Laparoscopic management of acute cholecystitis. Am J Surg. 1993; 165:508–514.

4. Knight JS, Mercer SJ, Somers SS, Walters AM, Sadek SA, Toh SK. Timing of urgent laparoscopic cholecystectomy does not influence conversion rate. Br J Surg. 2004; 91:601–604.

5. Houghton PW, Jenkinson LR, Donaldson LA. Cholecystectomy in the elderly: a prospective study. Br J Surg. 1985; 72:220–222.

6. Radder RW. Ultrasonically guided percutaneous catheter drainage for gallbladder empyema. Diagn Imaging. 1980; 49:330–333.

7. Vogelzang RL, Nemcek AA Jr. Percutaneous cholecystostomy: diagnostic and therapeutic efficacy. Radiology. 1988; 168:29–34.

8. Hultman CS, Herbst CA, McCall JM, Mauro MA. The efficacy of percutaneous cholecystostomy in critically ill patients. Am Surg. 1996; 62:263–269.

9. Welschbillig-Meunier K, Pessaux P, Lebigot J, et al. Percutaneous cholecystostomy for high-risk patients with acute cholecystitis. Surg Endosc. 2005; 19:1256–1259.

10. Byrne MF, Suhocki P, Mitchell RM, et al. Percutaneous cholecystostomy in patients with acute cholecystitis: experience of 45 patients at a US referral center. J Am Coll Surg. 2003; 197:206–211.

11. Okamoto K, Takada T, Strasberg SM, et al. Tokyo Guideline Revision Committee. TG13 management bundles for acute cholangitis and cholecystitis. J Hepatobiliary Pancreat Sci. 2013; 20:55–59.

12. Chikamori F, Kuniyoshi N, Shibuya S, Takase Y. Early scheduled laparoscopic cholecystectomy following percutaneous transhepatic gallbladder drainage for patients with acute cholecystitis. Surg Endosc. 2002; 16:1704–1707.

13. Han IW, Jang JY, Kang MJ, Lee KB, Lee SE, Kim SW. Early versus delayed laparoscopic cholecystectomy after percutaneous transhepatic gallbladder drainage. J Hepatobiliary Pancreat Sci. 2012; 19:187–193.

14. Yokoe M, Takada T, Strasberg SM, et al. Tokyo Guidelines Revision Committee. TG13 diagnostic criteria and severity grading of acute cholecystitis (with videos). J Hepatobiliary Pancreat Sci. 2013; 20:35–46.

15. Tokyo Guidelines for the management of acute cholangitis and cholecystitis. Proceedings of a consensus meeting, April 2006, Tokyo, Japan. J Hepatobiliary Pancreat Surg. 2007; 14:1–121.

16. Yamashita Y, Takada T, Strasberg SM, et al. Tokyo Guideline Revision Committee. TG13 surgical management of acute cholecystitis. J Hepatobiliary Pancreat Sci. 2013; 20:89–96.

17. Farooq T, Buchanan G, Manda V, Kennedy R, Ockrim J. Is early laparoscopic cholecystectomy safe after the "safe period"? J Laparoendosc Adv Surg Tech A. 2009; 19:471–474.

18. Huber DF, Martin EW Jr, Cooperman M. Cholecystectomy in elderly patients. Am J Surg. 1983; 146:719–722.

19. Majeski J. Laparoscopic cholecystectomy in geriatric patients. Am J Surg. 2004; 187:747–750.

20. Kiviniemi H, Mäkelä JT, Autio R, et al. Percutaneous cholecystostomy in acute cholecystitis in high-risk patients: an analysis of 69 patients. Int Surg. 1998; 83:299–302.

21. Kim HO, Ho Son B, Yoo CH, Ho Shin J. Impact of delayed laparoscopic cholecystectomy after percutaneous transhepatic gallbladder drainage for patients with complicated acute cholecystitis. Surg Laparosc Endosc Percutan Tech. 2009; 19:20–24.