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Cirugia Espanola Mar 2022
Topics: Arteries; Cholecystitis; Cholecystitis, Acute; Gallbladder Diseases; Humans
PubMed: 35216912
DOI: 10.1016/j.cireng.2022.02.009 -
Medicina (Kaunas, Lithuania) Dec 2023Gallbladder drainage is a treatment option in high-risk surgical patients with moderate or severe acute cholecystitis. It may be applied as a bridge to cholecystectomy... (Review)
Review
Gallbladder drainage is a treatment option in high-risk surgical patients with moderate or severe acute cholecystitis. It may be applied as a bridge to cholecystectomy or a definitive treatment option. Apart from the simple and widely accessible percutaneous cholecystostomy, new attractive techniques have emerged in the previous decade, including endoscopic transpapillary gallbladder drainage and endoscopic ultrasound-guided gallbladder drainage. The aim of this paper is to present currently available drainage techniques in the treatment of AC; evaluate their technical and clinical effectiveness, advantages, possible adverse events, and patient outcomes; and illuminate the decision-making path when choosing among various treatment modalities for each patient, depending on their clinical characteristics and the accessibility of methods.
Topics: Humans; Cholecystitis, Acute; Drainage; Cholecystostomy; Cholecystectomy; Treatment Outcome
PubMed: 38276039
DOI: 10.3390/medicina60010005 -
Abdominal Radiology (New York) Oct 2021To evaluate angle-corrected peak systolic cystic artery velocity (CAv) as a predictor of acute cholecystitis among patients presenting to the emergency department (ED)...
PURPOSE
To evaluate angle-corrected peak systolic cystic artery velocity (CAv) as a predictor of acute cholecystitis among patients presenting to the emergency department (ED) with right upper quadrant (RUQ) pain.
METHODS
In this IRB-approved and retrospective study, CAv was evaluated in 73 patients, 43 who underwent definitive treatment with cholecystectomy or percutaneous cholecystostomy and 30 control patients without clinical suspicion for cholecystitis. In addition to CAv, the following were reviewed by 3 radiologists: CBD diameter, cholelithiasis, impacted stone in the neck, sludge, gallbladder wall thickness > 3 mm, gallbladder transverse dimension ≥ 4 cm, longitudinal dimension ≥ 8 cm, tensile gallbladder fundus sign, pericholecystic fluid, pericholecystic echogenic fat, and sonographic Murphy sign.
RESULTS
Of the 43 patients who underwent definitive treatment, 25 had acute cholecystitis (34%) and 18 (25%) had chronic cholecystitis. Average CAv measurements were 50 ± 16 cm/s (acute), 28 ± 8 cm/s (chronic), and 22 ± 8 cm/s (control; p < 0.0001). In univariate analysis, among patients who underwent definitive therapy, CAv ≥ 40 cm/s, gallbladder wall thickness, stone impaction, GB long dimension ≥ 8 cm, and elevated WBC were associated with acute cholecystitis (p < 0.05). In multivariate analysis, CAv ≥ 40 cm/s was the only statistically significant variable (p = 0.016). CAv ≥ 40 cm/s alone had a PPV of 94.7% and overall accuracy of 81.4% in diagnosing acute cholecystitis.
CONCLUSION
CAv ≥ 40 cm/s is highly associated with acute cholecystitis in patients presenting to the ED with RUQ pain.
Topics: Cholecystitis; Cholecystitis, Acute; Hepatic Artery; Humans; Retrospective Studies
PubMed: 34216245
DOI: 10.1007/s00261-021-03020-z -
Surgical Infections Apr 2021
Topics: Acute Disease; Cholecystitis, Acute; Enterobacteriaceae; Humans
PubMed: 32640877
DOI: 10.1089/sur.2020.192 -
ANZ Journal of Surgery Sep 2016
Topics: Aged; Cholecystitis, Acute; Cholecystostomy; Cholelithiasis; Female; Humans
PubMed: 27586573
DOI: 10.1111/ans.13650 -
Journal of Visceral Surgery Feb 2013Acute calculous cholecystitis may progress in a variety of ways from mild cases treatable with (or even without) oral antibiotics to severe cases complicated by bile... (Review)
Review
Acute calculous cholecystitis may progress in a variety of ways from mild cases treatable with (or even without) oral antibiotics to severe cases complicated by bile peritonitis that require emergency surgical or radiological intervention. A sample of bile should always be sent for microbial cultures to identify aerobic and anaerobic bacterial organisms. Empirically selected broad spectrum antibiotic therapy (with a defined duration, dosage and administration route) should be prescribed according to the severity of the cholecystitis, an associated history of recent antibiotic therapy, and local bacterial susceptibility patterns. As soon as causative organisms have been identified, antibiotic therapy should be adjusted to a narrower spectrum antimicrobial agent based on the specific micro-organism(s) and the results of sensitivity testing.
Topics: Anti-Bacterial Agents; Bile; Cholecystectomy; Cholecystitis, Acute; Combined Modality Therapy; Drug Administration Schedule; Gallstones; Humans; Perioperative Care
PubMed: 23433832
DOI: 10.1016/j.jviscsurg.2013.01.004 -
Current Medical Imaging 2022Acute cholecystitis is a common clinical inflammatory lesion of the gallbladder. With the aggravation of inflammation, ischemic, necrosis, and even acute gangrenous...
Acute cholecystitis is a common clinical inflammatory lesion of the gallbladder. With the aggravation of inflammation, ischemic, necrosis, and even acute gangrenous cholecystitis occur in the gallbladder. At the same time, a variety of complications appear, seriously affecting the prognosis of patients. It is recommended that ultrasound can be utilized as the first choice for the diagnosis of acute cholecystitis, due to its fastness, convenience, non-radiation, and low cost. Here, we summarize the latest progress that can predict acute gangrenous cholecystitis in ultrasound, thus assisting us in identifying patients with high risk of gangrene in early stage, and treating these patients in time.
Topics: Cholecystitis, Acute; Gangrene; Humans; Ultrasonography
PubMed: 35319385
DOI: 10.2174/1573405618666220321124627 -
The Israel Medical Association Journal... May 2022The coronavirus disease 2019 (COVID-19) pandemic has had a significant impact on healthcare systems worldwide. The fear of seeking medical attention to avoid the...
BACKGROUND
The coronavirus disease 2019 (COVID-19) pandemic has had a significant impact on healthcare systems worldwide. The fear of seeking medical attention to avoid the possibility of being infected may have altered the course of some diseases.
OBJECTIVES
To describe our experience with the management of patients with acute cholecystitis during the pandemic at our medical center.
METHODS
We compared patients treated for acute cholecystitis between 1 March and 31 August 2020 (Group I) to patients admitted with the same diagnosis during the same months in 2019 (Group II). We evaluated demographics, presenting symptoms, laboratory and imaging findings at presentation, the disease's clinical course, management, and outcome.
RESULTS
Group I consisted of 101 patients and group II included 94 patients. No differences were noted for age (66 years, IQR 48-78 vs. 66 years, IQR 47-76; P = 0.50) and sex (57.4% vs. 51.1% females; P = 0.39) between the two groups. The delay between symptom onset and hospital admission was longer for Group I patients (3 days, IQR 2-7 vs. 2 days, IQR 1-3; P = 0.002). Moderate to severe disease was more commonly encountered in Group I (59.4% vs. 37.2%, P = 0.003). Group I patients more often failed conservative management (36% vs. 6%, P = 0.001) and had a higher conversion rate to open surgery (15.4% vs. 0%, P = 0.025).
CONCLUSIONS
Patients presenting with acute cholecystitis during the COVID-19 pandemic more often presented late to the emergency department and more showed adverse outcomes.
Topics: Aged; COVID-19; Cholecystitis, Acute; Disease Outbreaks; Female; Humans; Male; Middle Aged; Pandemics; Retrospective Studies
PubMed: 35598054
DOI: No ID Found -
Medicine Feb 2022Percutaneous transhepatic gallbladder drainage (PTGBD) is an alternative treatment option for acute cholecystitis. However, the disease may recur after PTGBD catheter...
Percutaneous transhepatic gallbladder drainage (PTGBD) is an alternative treatment option for acute cholecystitis. However, the disease may recur after PTGBD catheter removal. This study aimed to evaluate the role of endoscopic sphincterotomy and other risk factors in reducing the recurrence of cholecystitis.We retrospectively analyzed data from 1088 patients who underwent PTGBD for cholecystitis at Kyungpook National University Hospital, Republic of Korea, between January 2011 and April 2018.A total of 115 patients were enrolled in the study. The recurrence rate of cholecystitis was 17.4% (n = 20) during a median follow-up period of 1159 (range, 369-2774) days. Endoscopic biliary sphincterotomy did not significantly affect the recurrence rate of cholecystitis (P = .561). In multivariable analysis, cystic duct stones (P = .013) and PTGBD catheter migration before the prescheduled removal time (P = .002) were identified as independent risk factors for cholecystitis recurrence after PTGBD.To reduce post-PTGBD recurrence in cholecystitis, caution must be exercised to avoid inadvertent dislodging of the PTGBD catheter. In cases of cholecystitis with cystic duct stones, cholecystectomy should be considered only after careful assessment of postoperative risks. Instead, transluminal endoscopic gallbladder drainage could represent a promising option for the prevention of recurrent cholecystitis.
Topics: Catheters; Cholecystitis, Acute; Cholecystolithiasis; Cholecystostomy; Device Removal; Drainage; Gallbladder; Humans; Recurrence; Retrospective Studies; Sphincterotomy, Endoscopic; Treatment Outcome
PubMed: 35119038
DOI: 10.1097/MD.0000000000028767 -
The American Journal of Case Reports Sep 2015Portal vein thrombosis (PVT) is an infrequent clinical condition usually associated with multiple etiological factors and diseases. In some cases, PVT remains... (Review)
Review
BACKGROUND
Portal vein thrombosis (PVT) is an infrequent clinical condition usually associated with multiple etiological factors and diseases. In some cases, PVT remains undiagnosed and is incidentally detected during routine examination for a known etiology.
CASE REPORT
Here, we present a rare case of portal vein thrombosis associated with acute cholecystitis in a 31-year-old man.
CONCLUSIONS
Conservative treatment may be a feasible and safe approach for the management of PVT with acute cholecystitis, if treated at an early stage. Moreover, initial diagnosis based on radiological evaluation is possible only if the surgeons are familiar with this unusual condition. Therefore, a high index of suspicion is required for early diagnosis and management of patients with acute cholecystitis-associated PVT.
Topics: Adult; Cholecystitis, Acute; Humans; Male; Portal Vein; Venous Thrombosis
PubMed: 26378714
DOI: 10.12659/AJCR.894846