Show simple item record

dc.contributor.authorCherng, Nicole
dc.contributor.authorWitkowski, Elan R.
dc.contributor.authorSneider, Erica B.
dc.contributor.authorWiseman, Jason T.
dc.contributor.authorLewis, Joanne
dc.contributor.authorLitwin, Demetrius E. M.
dc.contributor.authorSantry, Heena P.
dc.contributor.authorCahan, Mitchell A.
dc.contributor.authorShah, Shimul A.
dc.date2022-08-11T08:10:55.000
dc.date.accessioned2022-08-23T17:24:31Z
dc.date.available2022-08-23T17:24:31Z
dc.date.issued2012-02-01
dc.date.submitted2012-11-13
dc.identifier.citationJ Am Coll Surg. 2012 Feb;214(2):196-201. Epub 2011 Dec 21. <a href="http://dx.doi.org/10.1016/j.jamcollsurg.2011.11.005">Link to article on publisher's site</a>
dc.identifier.issn1072-7515 (Linking)
dc.identifier.doi10.1016/j.jamcollsurg.2011.11.005
dc.identifier.pmid22192897
dc.identifier.urihttp://hdl.handle.net/20.500.14038/49209
dc.description<p>Jason Wiseman participated in this study as a medical student as part of the Senior Scholars research program at the University of Massachusetts Medical School.</p>
dc.description.abstractBACKGROUND: Management of patients with severe acute cholecystitis (AC) remains controversial. In settings where laparoscopic cholecystectomy (LC) can be technically challenging or medical risks are exceedingly high, surgeons can choose between different options, including LC conversion to open cholecystectomy or surgical cholecystostomy tube (CCT) placement, or initial percutaneous CCT. We reviewed our experience treating complicated AC with CCT at a tertiary-care academic medical center. STUDY DESIGN: All adult patients (n = 185) admitted with a primary diagnosis of AC and who received CCT from 2002 to 2010 were identified retrospectively through billing and diagnosis codes. RESULTS: Mean patient age was 71 years and 80% had >/=1 comorbidity (mean 2.6). Seventy-eight percent of CCTs were percutaneous CCT placement and 22% were surgical CCT placement. Median length of stay from CCT insertion to discharge was 4 days. The majority (57%) of patients eventually underwent cholecystectomy performed by 20 different surgeons in a median of 63 days post-CCT (range 3 to 1,055 days); of these, 86% underwent LC and 13% underwent open conversion or open cholecystectomy. In the radiology and surgical group, 50% and 80% underwent subsequent cholecystectomy, respectively, at a median of 63 and 60 days post-CCT. Whether surgical or percutaneous CCT placement, approximately the same proportion of patients (85% to 86%) underwent LC as definitive treatment. CONCLUSIONS: This 9-year experience shows that use of CCT in complicated AC can be a desirable alternative to open cholecystectomy that allows most patients to subsequently undergo LC. Additional studies are underway to determine the differences in cost, training paradigms, and quality of life in this increasingly high-risk surgical population. rights reserved.
dc.language.isoen_US
dc.relation<a href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=pubmed&cmd=Retrieve&list_uids=22192897&dopt=Abstract">Link to Article in PubMed</a>
dc.relation.urlhttp://dx.doi.org/10.1016/j.jamcollsurg.2011.11.005
dc.subjectAged
dc.subjectCholecystitis, Acute
dc.subjectCholecystography
dc.subjectCholecystostomy
dc.subjectCritical Illness
dc.subjectDecompression, Surgical
dc.subjectDigestive System Surgical Procedures
dc.subjectFemale
dc.subjectHumans
dc.subjectMale
dc.subjectMiddle Aged
dc.subjectQuality of Life
dc.subjectRetrospective Studies
dc.subject*Stents
dc.subjectTreatment Outcome
dc.subjectLife Sciences
dc.subjectMedicine and Health Sciences
dc.titleUse of cholecystostomy tubes in the management of patients with primary diagnosis of acute cholecystitis
dc.typeJournal Article
dc.source.journaltitleJournal of the American College of Surgeons
dc.source.volume214
dc.source.issue2
dc.identifier.legacycoverpagehttps://escholarship.umassmed.edu/ssp/147
dc.identifier.contextkey3463772
html.description.abstract<p>BACKGROUND: Management of patients with severe acute cholecystitis (AC) remains controversial. In settings where laparoscopic cholecystectomy (LC) can be technically challenging or medical risks are exceedingly high, surgeons can choose between different options, including LC conversion to open cholecystectomy or surgical cholecystostomy tube (CCT) placement, or initial percutaneous CCT. We reviewed our experience treating complicated AC with CCT at a tertiary-care academic medical center.</p> <p>STUDY DESIGN: All adult patients (n = 185) admitted with a primary diagnosis of AC and who received CCT from 2002 to 2010 were identified retrospectively through billing and diagnosis codes.</p> <p>RESULTS: Mean patient age was 71 years and 80% had >/=1 comorbidity (mean 2.6). Seventy-eight percent of CCTs were percutaneous CCT placement and 22% were surgical CCT placement. Median length of stay from CCT insertion to discharge was 4 days. The majority (57%) of patients eventually underwent cholecystectomy performed by 20 different surgeons in a median of 63 days post-CCT (range 3 to 1,055 days); of these, 86% underwent LC and 13% underwent open conversion or open cholecystectomy. In the radiology and surgical group, 50% and 80% underwent subsequent cholecystectomy, respectively, at a median of 63 and 60 days post-CCT. Whether surgical or percutaneous CCT placement, approximately the same proportion of patients (85% to 86%) underwent LC as definitive treatment.</p> <p>CONCLUSIONS: This 9-year experience shows that use of CCT in complicated AC can be a desirable alternative to open cholecystectomy that allows most patients to subsequently undergo LC. Additional studies are underway to determine the differences in cost, training paradigms, and quality of life in this increasingly high-risk surgical population. rights reserved.</p>
dc.identifier.submissionpathssp/147
dc.contributor.departmentSenior Scholars Program
dc.contributor.departmentDepartment of Surgery, Surgical Outcomes Analysis and Research (SOAR)
dc.contributor.departmentSchool of Medicine
dc.source.pages196-201
dc.contributor.studentNicole Cherng


Files in this item

Thumbnail
Name:
Publisher version

This item appears in the following Collection(s)

Show simple item record