Cholecystostomy Drainage - Current Practices in a Tertiary Hepatobiliary Unit.

Q3 Medicine

Irish medical journal Pub Date : 2026-09-28

M Al Azzawi, C Drumm, C Cullinane, C Manole, A Coffey, D O'Neill, C O'Sulleabhain, A O'Sullivan, T Murphy

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引用次数: 0

Abstract

Background: Acute calculous cholecystitis (ACC) is a common general surgical emergency and accounts for 20% of symptomatic gallstone presentations. According to the Tokyo Guidelines, severe ACC necessitates cholecystostomy drainage. Percutaneous Cholecystostomy Drains (PCD) are a temporary intervention in acutely unwell patients with gallbladder-related disease who are unfit to undergo surgery. PCD is used with a therapeutic or palliative intent for the management of gallbladder disease based on the condition and the patient's fitness. This study aims to assess the current role of PCDs in a tertiary hepatobiliary referral centre.

Methods: This was a retrospective review of PCD patients treated in a tertiary hepatobiliary referral centre between January 2018 and December 2023. Clinical, radiological, and perioperative outcomes were measured. Descriptive analysis was performed using GraphPad Prism.

Results: Sixty-eight patients were identified over six years. The mean age was 71.6 years, with a male majority. The most common diagnosis was severe cholecystitis with septic shock (23, 33.8%), followed by gallbladder perforation (18, 26.4%). The mean duration of PCD placement was 95.78 days. A post-drainage cholecystectomy was performed in 7 (87.1%) of patients with ASA I-II and 24 (40%) with ASA III-IV (p-value<0.05).

Conclusions: PCDs are safe and effective in managing surgically unfit patients with severe, complicated ACC. There is a paucity of literature on specific guidelines for the indications, follow-up, and management of PCDs.

本刊更多论文

胆囊造瘘引流-三级肝胆科的现行做法。

背景：急性结石性胆囊炎（ACC）是一种常见的普通外科急症，占症状性胆结石的20%。根据东京指南，严重的ACC需要胆囊造瘘引流。经皮胆囊造瘘引流术（PCD）是一种临时干预急性不适患者胆囊相关疾病，不适合接受手术。PCD是用于治疗或姑息意图管理胆囊疾病的基础上的条件和病人的健康。本研究旨在评估目前PCDs在三级肝胆转诊中心的作用。方法：回顾性分析2018年1月至2023年12月在三级肝胆转诊中心治疗的PCD患者。测量临床、放射学和围手术期结果。使用GraphPad Prism进行描述性分析。结果：68例患者在6年内被确定。平均年龄为71.6岁，男性居多。最常见的诊断是严重胆囊炎合并感染性休克（23.33.8%），其次是胆囊穿孔（18.26.4%）。PCD放置的平均时间为95.78天。ASA I-II型患者中有7例（87.1%）行引流后胆囊切除术，ASA III-IV型患者中有24例（40%）行引流后胆囊切除术（p值）。结论：PCDs对于治疗不适合手术的严重并发症ACC患者是安全有效的。关于慢性阻塞性肺病的适应症、随访和管理的具体指南缺乏文献。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Irish medical journal Medicine-Medicine (all)

CiteScore

1.00

自引率

0.00%

发文量

139

期刊介绍： Since its inception in 1867, the Journal of the Medical Association of Ireland and now in its present format, the Irish Medical Journal, has provided the medical community in Ireland with an invaluable service. As one of the leading biomedical publications in Ireland, it has sought to continue the education of medical students and postgraduates through scientific research, review articles and updates on contemporary clinical practices while providing an ongoing forum for medical debate. A measure of our stature is that we are listed in the Index Medicus and issued annually with a citation factor from the Institute for Scientific Information.