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Cholecystostomy: Its Place in the Treatment of Acute Cholecystitis.

David L. Collins, Frank B. Thomson

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Abstract

Conservative management of acute cholecystitis has frequently been too prolonged, particularly in the aged. Early cholecystostomy followed by interval cholecystectomy improved the results of treatment as demonstrated in a series of 41 patients at Shaughnessy Veterans Hospital, Vancouver. The following advantages were noted. Advanced disease in the elderly toxic patient was successfully treated by a minor and short surgical procedure, cholecystostomy. Per-cholecystostomy cholangiography revealed dilatation and/or stones in the common bile duct. Interval cholecystectomy was facilitated by the absence of general toxicity, by the presence of a subsiding inflammatory process, and by the availability preoperatively of knowledge of the status of the common bile duct.

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Conservative management of acute cholecystitis has frequently been too prolonged, particularly in the aged. Early cholecystostomy followed by interval cholecystectomy improved the results of treatment as demonstrated in a series of 41 patients at Shaughnessy Veterans Hospital, Vancouver. The following advantages were noted. Advanced disease in the elderly toxic patient was successfully treated by a minor and short surgical procedure, cholecystostomy. Per-cholecystostomy cholangiography revealed dilatation and/or stones in the common bile duct. Interval cholecystectomy was facilitated by the absence of general toxicity, by the presence of a subsiding inflammatory process, and by the availability preoperatively of knowledge of the status of the common bile duct.

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Available abstract

Conservative management of acute cholecystitis has frequently been too prolonged, particularly in the aged. Early cholecystostomy followed by interval cholecystectomy improved the results of treatment as demonstrated in a series of 41 patients at Shaughnessy Veterans Hospital, Vancouver. The following advantages were noted. Advanced disease in the elderly toxic patient was successfully treated by a minor and short surgical procedure, cholecystostomy. Per-cholecystostomy cholangiography revealed dilatation and/or stones in the common bile duct. Interval cholecystectomy was facilitated by the absence of general toxicity, by the presence of a subsiding inflammatory process, and by the availability preoperatively of knowledge of the status of the common bile duct.

Key concepts: Cholecystostomy, Medicine, Acute cholecystitis, Cholecystectomy, Cholecystitis, General surgery, Common bile duct, Bile duct

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