PERCUTANEOUS CHOLECYSTOSTOMY FOR ACUTE CHOLECYSTITIS IN CRITICALLY-ILL PATIENTS

Background. Cholecystectomy remains the best treatment for acute chole cystitis but may cause high morbidity or mortality in critically ill o r elderly patients. Methods. We report a retrospective study of ultras onography-guided percutaneous cholecystostomy (USGPC) performed betwee n 1988 and 1994 in 41 patients (mean age, 77.8 years; range, 42-95 yea rs) as an alternative surgery. Results. Five patients (12.2%) died in the hospital, four (9.8%) subsequently underwent operation without com plications, six (15%) had a recurrence of cholecystitis between 3 and 24 months after withdrawal of drainage, and 26 patients are cured with out recurrence after a mean follow-up of 33 months (range, 3-67 months ). Conclusions. USGPC appears to be the treatment of choice for high-r isk patients, especially those with postoperative cholecystitis, sever e acute calculous pancreatitis, or total parenteral nutrition.