Re-Arousal of a Vanishing Surgical Procedure: Application of Surgical Cholecystostomy in Critically Ill or Non-Percutaneous-Cholecystostomy Fit Patients of Acute Cholecystitis

Liu HP and Wu YC

Department of General Surgery, Kaohsiung Armed Forces General Hospital, Taiwan
Zuoying Branch of Kaohsiung Armed Forces General Hospital, Taiwan
R.O.C. Military Academy, Taiwan

^*Correspondance to: Yu-Chiuan Wu 

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Abstract:

Today, Surgical Cholecystostomy (SC) is nearly replaced by image-guide percutaneous techniques, and it’s been scarcely mentioned since 1980s after the introduction of Percutaneous Cholecystostomy (PC). However, SC may be needed in some situations. Cholecystostomy has been shown to be beneficial in high-risk patient groups to decompress the gallbladder, reducing patients’ symptoms and the systemic inflammatory response. It also has been proven to be the most feasible bridging treatment prior to elective cholecystectomy. The majority of PC has often been performed via transhepatic route, transversing the liver for theoretically greater catheter stability and lower rate of bile leakage. The transperitoneal route is considered a more suitable option for patients with liver disease and uncorrected coagulopathy. To date, either route of PC is executed with the help of sonography or computerized tomography by radiologist, and that is not always available in some developing districts. Herein, we would introduce this forgotten surgery, SC, to reach the goal of bile diversion similar to transperitoneal PC. We enrolled the total of 9 patients with acute cholecystitis not suitable for transhepatic route, underwent SC since 1999 to 2016 in a single institute. The reasons for the operation of SC are as below: 1. Liver cirrhosis with coagulopathy. 2. Sepsis with coagulopathy. 3. Gallbladder empyema with rupture. 4. Unavailability of radiologist. Among these 9 patients, 6 have undergone following cholecystectomy. And all of the 9 patients were uneventful during 1-year follow-up.

Keywords:

Percutaneous cholecystostomy; Surgical cholecystostomy; Acute Cholecystitis

Cite the Article:

Liu HP, Wu YC. Re-Arousal of a Vanishing Surgical Procedure: Application of Surgical Cholecystostomy in Critically Ill or Non-PercutaneousCholecystostomy Fit Patients of Acute Cholecystitis. World J Surg Surgical Res. 2023; 6: 1467..