PMID- 10434447
OWN - NLM
STAT- MEDLINE
DCOM- 19990818
LR  - 20161124
IS  - 0003-469X (Print)
IS  - 0003-469X (Linking)
VI  - 70
IP  - 2
DP  - 1999 Mar-Apr
TI  - [Echo-guided percutaneous cholecystostomy in the treatment of acute 
      cholecystitis].
PG  - 169-72
AB  - Ultrasound-guided cholecystostomy (UGC) is indicated for high-risk patients with 
      acute cholecystitis (AC). The advantage of this approach is greatest for 
      critically ill patients who develop AC while in the intensive care unit (ICU). 
      Moreover, in ICU patients with unexplained sepsis UGC serves as a diagnostic 
      maneuver since it may allow the identification of a biliary infection. UGC has a 
      high therapeutic efficacy approaching 100% in patients with a well-established 
      diagnosis of AC. Morbidity is low and almost entirely related to catheter 
      dislodgment. Trans-catheter cholecystocholangiograms (TCC), indispensable for 
      planning any further treatment, must be delayed until the resolution of the 
      sepsis. The risk of recurrence depends on AC etiology. Acalculous AC entails a 
      low recurrence risk and may often be managed non-operatively. After the 
      resolution of the sepsis, all calculous AC should be considered for 
      cholecystectomy. However, if the operative risk remains high the possibility of 
      avoiding the operation depends on the TCC demonstration of the patency of the 
      cystic duct. The catheter should remain in place until operation. In case of 
      non-operative management withdrawal should be delayed until the resolution of the 
      sepsis. Laparoscopy is suitable in case of recent inflammation.
FAU - Mosca, F
AU  - Mosca F
AD  - Dipartimento di Oncologia, Universita degli Studi di Pisa.
LA  - ita
PT  - Journal Article
TT  - La colecistostomia percutanea ecoguidata nel trattamento delle colecistiti acute.
PL  - Italy
TA  - Ann Ital Chir
JT  - Annali italiani di chirurgia
JID - 0372343
SB  - IM
MH  - Acute Disease
MH  - Cholecystectomy
MH  - Cholecystectomy, Laparoscopic
MH  - Cholecystitis/diagnostic imaging/*surgery
MH  - Cholecystostomy/*methods
MH  - Follow-Up Studies
MH  - Gallbladder/diagnostic imaging
MH  - Humans
MH  - Ultrasonography, Interventional/*methods
EDAT- 1999/08/06 00:00
MHDA- 1999/08/06 00:01
CRDT- 1999/08/06 00:00
PHST- 1999/08/06 00:00 [pubmed]
PHST- 1999/08/06 00:01 [medline]
PHST- 1999/08/06 00:00 [entrez]
PST - ppublish
SO  - Ann Ital Chir. 1999 Mar-Apr;70(2):169-72.