Cholecystostomy. Expected outcome in primary and secondary biliary disorders

Gregory Jurkovich, D. L. Dyess, J. J. Ferrara

Research output: Contribution to journalArticlepeer-review

11 Scopus citations

Abstract

Cholecystostomy is used for biliary-tree drainage when simplicity and speed are of prime importance. Its frequency of use and the subsequent mortality rates, vary among surgeons and institutions. This review analyzes 50 cholecystostomies performed over 6 years at one institution, and defines outcome as related to presenting symptoms. Twenty five other patients (Group 1) presented with symptoms of acute cholecystitis, and underwent cholecystostomy. Twenty (80%) had gallstones and five (20%) were acalculous. Two patients died, a mortality rate of 8 per cent. Twenty five patients (Group 2) developed signs suggesting cholecystitis during hospitalization for an unrelated illness. Only 50 per cent (13/25) of Group 2 patients were found to have cholecystitis at operation (eight calculous, five acalculous). Mortality was 62 per cent (8/13) in the Group 2 patients with inflammatory cholecystitis, and 50 per cent (6/12) for the patients with normal gallbladders. A positive outcome may be anticipated if cholecystostomy is used in patients admitted with acute cholecystitis who present too great a surgical risk for formal cholecystectomy. In contrast, the diagnosis of cholecystitis in the critically ill patient can be difficult and the prognosis for survival is not good, even after cholecystostomy.

Original languageEnglish (US)
Pages (from-to)40-44
Number of pages5
JournalAmerican Surgeon
Volume54
Issue number1
StatePublished - Jan 1 1988
Externally publishedYes

ASJC Scopus subject areas

  • Surgery

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