Percutaneous Cholecystostomy Via Intraperitoneal Approach in Acute Obstructive Cholecystitis
https://doi.org/10.16931/1995-5464.2018-1-96-103
Abstract
Aim. To determine the possibility, feasibility and safety of intraperitoneal approach to gallbladder for percutaneous microcholecystostomy.
Material and Methods. There were 384 high risk patients with acute obstructive calculous cholecystitis who underwent percutaneous microcholecystostomy within 2012–2016. In 287 (74.7%) patients cholecystostomy was deployed via percutaneous intraperitoneal approach, in 97 (25.3%) – extraperitoneal percutaneous transhepatic access through gallbladder bed. Percutaneous intraperitoneal microcholecystostomy in 55 patients and percutaneous transhepatic (extraperitoneal) microcholecystostomy in 97 patients became compelled final treatment of acute obstructive cholecystitis.
Results. In 1 case of percutaneous transhepatic microcholecystostomy intravesical bleeding occurred, which was stopped with medication. Drainage tube displacement was observed in 16 (16.5%) cases. There were no hemorrhagic complications after percutaneous microcholecystostomy with intraperitoneal access, drainage tube displacement within the first 3 days occurred in 52 (18.1%) cases. In 22 (32.4%) patients drainage tube displacement was followed by focal bile accumulation under gallbladder or diaphragm that required additional drainage.
Conclusion. Intra- and extraperitoneal accesses to the gallbladder for microcholecystostomy have equivalent effectiveness and safety for obstructive acute cholecystitis management in high risk patients.
About the Authors
O. I. Okhotnikov
Kursk Regional Clinical Hospital; X-ray Surgical Department
Kursk State Medical University, Healthcare Ministry of the Russian Federation
Russian Federation
Russian Federation
45a, Sumskaya str., Kursk, 305007, Russian Federation
3, K. Marks str., Kursk, 305041, Russian Federation
Phone: +7-910-740-20-92
Doct. of Med. Sci., Professor, Head of the X-ray Surgical Department №2, Kursk Regional Clinical Hospital, Professor of the Chair of Medical Radiology of Kursk State Medical University
M. V. Yakovleva
Kursk Regional Clinical Hospital; X-ray Surgical Department
Kursk State Medical University, Healthcare Ministry of the Russian Federation
Russian Federation
Russian Federation
45a, Sumskaya str., Kursk, 305007, Russian Federation
3, K. Marks str., Kursk, 305041, Russian Federation
Cand. of Med. Sci., Associate Professor of the Chair of Surgical Diseases, Kursk State Medical University; Surgeon at the X-ray Surgical Department №2, Kursk Regional Clinical Hospital
S. N. Grigoriev
Kursk Regional Clinical Hospital; X-ray Surgical Department
Russian Federation
Russian Federation
45a, Sumskaya str., Kursk, 305007, Russian Federation
Cand. of Med. Sci., Head of the Department of Suppurative Surgery, Kursk Regional Clinical Hospital, Surgeon of the X-ray Surgical Department №2, Kursk Regional Clinical Hospital
V. I. Pakhomov
Kursk Regional Clinical Hospital; X-ray Surgical Department
Russian Federation
Russian Federation
45a, Sumskaya str., Kursk, 305007, Russian Federation
Surgeon of the X-ray Surgical Department №2, Kursk Regional Clinical Hospital
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For citations:
Okhotnikov O.I., Yakovleva M.V., Grigoriev S.N., Pakhomov V.I. Percutaneous Cholecystostomy Via Intraperitoneal Approach in Acute Obstructive Cholecystitis. Annaly khirurgicheskoy gepatologii = Annals of HPB Surgery. 2018;23(1):96-103. (In Russ.) https://doi.org/10.16931/1995-5464.2018-1-96-103
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