Delayed Cholecystectomy for Acute Cholecystitis in Elderly Patients Treated Primarily with Antibiotics or Percutaneous Drainage of the Gallbladder.

Details

Serval ID
serval:BIB_F4D06C822C5F
Type
Article: article from journal or magazin.
Collection
Publications
Institution
Title
Delayed Cholecystectomy for Acute Cholecystitis in Elderly Patients Treated Primarily with Antibiotics or Percutaneous Drainage of the Gallbladder.
Journal
Journal of laparoendoscopic & advanced surgical techniques. Part A
Author(s)
Joliat G.R., Longchamp G., Du Pasquier C., Denys A., Demartines N., Melloul E.
ISSN
1557-9034 (Electronic)
ISSN-L
1092-6429
Publication state
Published
Issued date
09/2018
Peer-reviewed
Oui
Volume
28
Number
9
Pages
1094-1099
Language
english
Notes
Publication types: Journal Article
Publication Status: ppublish
Abstract
In high-risk patients with acute cholecystitis, antibiotics with or without percutaneous drainage of the gallbladder followed by delayed cholecystectomy (DC) can be performed. This study aimed to review our current management of elderly patients with acute cholecystitis treated with DC.
All consecutive patients older than 70 with acute cholecystitis treated primarily with antibiotics with or without percutaneous drainage followed by DC between 2006 and 2015 were retrospectively reviewed.
Overall 105 elderly patients had acute cholecystitis with planned DC. Ninety-three patients had antibiotherapy alone at first. Twenty-eight patients needed percutaneous drainage either in intention to treat (n = 12) or due to failure of antibiotic treatment (n = 16). Nine (32%) versus 11 patients (12%) required an emergency cholecystectomy (EC) due to failure of percutaneous drainage or antibiotic treatment, respectively. Eighteen patients (64%) underwent DC after percutaneous drainage. Postoperative morbidity was 39% (7/18) after DC in the percutaneous drainage group, and 1 patient died. Compared to DC after antibiotherapy (n = 53), elderly patients who underwent DC after percutaneous drainage (n = 18) had longer median hospital stay (10 days versus 3 days, P = .001) and higher postoperative complications (7/18 versus 6/53, P = .015).
In elderly patients with acute cholecystitis, DC can be a good alternative to EC. However, after percutaneous drainage DC is associated with high complication rate and long hospital stay.
Keywords
Aged, Aged, 80 and over, Anti-Bacterial Agents/therapeutic use, Cholecystectomy/adverse effects, Cholecystitis, Acute/drug therapy, Cholecystitis, Acute/surgery, Combined Modality Therapy, Drainage, Emergencies, Female, Gallbladder/surgery, Humans, Length of Stay, Male, Postoperative Complications/surgery, Retrospective Studies, Time Factors, antibiotherapy, cholecystectomy, cholecystostomy, percutaneous drainage
Pubmed
Web of science
Create date
03/05/2018 18:02
Last modification date
11/02/2021 12:55
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