Perkütan Kolesistostominin Akut Kolesistit Tedavisindeki Yeri

Year 2023, Volume: 13 Issue: 1, 70 - 83, 16.03.2023

Erbil Arık , Asım Esenkaya , Fatih Altıntoprak

https://doi.org/10.31832/smj.1215454

Abstract

Amaç: Çalışmamızda perkütan kolesistostominin (PK) hastaların klinik ve laboratuvar bulgularına etkisini araştırdık.

Gereç ve Yöntem: Çalışmamıza Şubat 2017 ile Kasım 2018 tarihleri arasında PK yapılan 36 hasta dahil edildi.Hastaların işlem öncesi ve sonrası klinik ve laboratuvar bulguları retrospektif olarak tarandı.

Bulgular: Hastalarımızda rekürrens görülmemiştir. PK işlemi ile ilişkili mortalite ya da komplikasyon izlenmemiştir. Kateterin takılı kalma süresi 50,2 ± 26,1 gün, hastane yatış süresi 7,5 ± 5,2 gün olarak belirlenmiştir. Total bilirubin değeri ve beyaz küre sayısı yüksek olan hasta sayısında işlem öncesi ve sonrası arasında istatistiksel olarak anlamlı fark saptanmıştır. ALT, ALP, CRP, beyaz küre sayısı, total ve direkt bilirubin parametrelerinin işlem öncesi ve sonrası değerleri arasında da istatistiksel olarak anlamlı fark saptanmıştır. Tokyo kılavuzu evresi ile yoğun bakım ihtiyacı arasında istatistiksel olarak anlamlı fark saptanmış olup yoğun bakımda tedavi gösteren tüm hastalar evre 3’tür.PK sonrasında cerrahiye giden hastaların yaş ortalaması diğer gruba göre daha yüksektir.

Sonuç: İşlem sonrasında beyaz küre sayısı ve CRP değerinde anlamlı düşüş ve hastaların çoğunluğunda klinik düzelme görülmesi PK’nin A.K kaynaklı enflamatuar süreçleri olumlu yönde etkilediğini göstermektedir. Çalışmamızda işlem sonrasında ALT ve ALP değerlerinde anlamlı düşüş saptanmış olup, bu bulgu bildiğimiz kadarıyla literatürde ilk kez tanımlanmıştır.

Keywords

akut kolesistit, perkütan kolesistostomi, perkütan safra kesesi drenajı, safra kesesi, kolesistektomi

References

• 1. Knab LM, Boller AM, Mahvi DM. Cholecystitis. Surg Clin North Am. 2014;94(2):455-470. doi:10.1016/j.suc.2014.01.005
• 2. Katabathina VS, Zafar AM, Suri R. Clinical Presentation, Imaging, and Management of Acute Cholecystitis. Techniques in Vascular & Interventional Radiology. 2015;18(4):256-265. doi:10.1053/j.tvir.2015.07.009
• 3. Yokoe M, Hata J, Takada T, Strasberg SM, Asbun HJ, Wakabayashi G, et al. Tokyo Guidelines 2018: diagnostic criteria and severity grading of acute cholecystitis (with videos). Journal of Hepato-Biliary-Pancreatic Sciences. 2018;25(1):41-54. doi:10.1002/jhbp.515
• 4. Rumack CM, Charboneau JW, Levine D, Wilson SR. Diagnostic Ultrasound. In: Diagnostic Ultrasound. Vol 1. 4th ed. Mosby; 2011:197-213.
• 5. Shakespear JS, Shaaban AM, Rezvani M. CT Findings of Acute Cholecystitis and Its Complications. American Journal of Roentgenology. 2010;194(6):1523-1529. doi:10.2214/AJR.09.3640
• 6. Okamoto K, Suzuki K, Takada T, Strasberg SM, Asbun HJ, Endo I, et al. Tokyo Guidelines 2018: flowchart for the management of acute cholecystitis. Journal of Hepato-Biliary-Pancreatic Sciences. 2018;25(1):55-72. doi:10.1002/jhbp.516
• 7. Wible BC. Diagnostic Imaging: Interventional Procedures. In: Diagnostic Imaging: Interventional Procedures. 2nd ed. Elsevier Amirsys; 2018:752-754.
• 8. Kaufman JA, Lee MJ. Vascular and Interventional Radiology: The Requisites. In: Vascular and Interventional Radiology: The Requisites. 2nd ed. Elsevier; 2014:395-399.
• 9. Jang WS, Lim JU, Joo KR, Cha JM, Shin HP, Joo SH. Outcome of conservative percutaneous cholecystostomy in high-risk patients with acute cholecystitis and risk factors leading to surgery. Surg Endosc. 2015;29(8):2359-2364. doi:10.1007/s00464-014-3961-4
• 10. Di Martino M, Miguel Mesa D, Lopesino González JM, de la Hoz Rodríguez Á, Martín-Pérez E. Safety of Percutaneous Cholecystostomy Early Removal: A Retrospective Cohort Study. Surg Laparosc Endosc Percutan Tech. 2020;30(5):410-415. doi:10.1097/SLE.0000000000000799
• 11. Bundy J, Srinivasa RN, Gemmete JJ, Shields JJ, Chick JFB. Percutaneous Cholecystostomy: Long-Term Outcomes in 324 Patients. Cardiovasc Intervent Radiol. 2018;41(6):928-934. doi:10.1007/s00270-018-1884-5
• 12. Cooper S, Donovan M, Grieve DA. Outcomes of percutaneous cholecystostomy and predictors of subsequent cholecystectomy. ANZ Journal of Surgery. 2018;88(7-8):E598-E601. doi:10.1111/ans.14251
• 13. Pang KW, Tan CHN, Loh S, Chang KYS, Iyer SG, Madhavan K, et al. Outcomes of Percutaneous Cholecystostomy for Acute Cholecystitis. World J Surg. 2016;40(11):2735-2744. doi:10.1007/s00268-016-3585-z
• 14. Colonna AL, Griffiths TM, Robison DC, Enniss TM, Young JB, McCrum ML, et al. Cholecystostomy: Are we using it correctly? Am J Surg. 2019;217(6):1010-1015. doi:10.1016/j.amjsurg.2019.04.002
• 15. Horn T, Christensen SD, Kirkegård J, Larsen LP, Knudsen AR, Mortensen FV. Percutaneous cholecystostomy is an effective treatment option for acute calculous cholecystitis: a 10-year experience. HPB (Oxford). 2015;17(4):326-331. doi:10.1111/hpb.12360
• 16. Sanjay P, Mittapalli D, Marioud A, White RD, Ram R, Alijani A. Clinical outcomes of a percutaneous cholecystostomy for acute cholecystitis: a multicentre analysis. HPB (Oxford). 2013;15(7):511-516. doi:10.1111/j.1477-2574.2012.00610.x
• 17. Little MW, Briggs JH, Tapping CR, Bratby MJ, Anthony S, Phillips-Hughes J, et al. Percutaneous cholecystostomy: the radiologist’s role in treating acute cholecystitis. Clin Radiol. 2013;68(7):654-660. doi:10.1016/j.crad.2013.01.017
• 18. Choi JW, Park SH, Choi SY, Kim HS, Kim TH. Comparison of clinical result between early laparoscopic cholecystectomy and delayed laparoscopic cholecystectomy after percutaneous transhepatic gallbladder drainage for patients with complicated acute cholecystitis. Korean J Hepatobiliary Pancreat Surg. 2012;16(4):147-153. doi:10.14701/kjhbps.2012.16.4.147
• 19. Han IW, Jang JY, Kang MJ, Lee KB, Lee SE, Kim SW. Early versus delayed laparoscopic cholecystectomy after percutaneous transhepatic gallbladder drainage. J Hepatobiliary Pancreat Sci. 2012;19(2):187-193. doi:10.1007/s00534-011-0458-6
• 20. Jung WH, Park DE. Timing of Cholecystectomy after Percutaneous Cholecystostomy for Acute Cholecystitis. Korean J Gastroenterol. 2015;66(4):209-214. doi:10.4166/kjg.2015.66.4.209
• 21. Inoue K, Ueno T, Nishina O, Douchi D, Shima K, Goto S, et al. Optimal timing of cholecystectomy after percutaneous gallbladder drainage for severe cholecystitis. BMC Gastroenterol. 2017;17(1):71. doi:10.1186/s12876-017-0631-8
• 22. Chang YR, Ahn YJ, Jang JY, Kang MJ, Kwon W, Jung WH, et al. Percutaneous cholecystostomy for acute cholecystitis in patients with high comorbidity and re-evaluation of treatment efficacy. Surgery. 2014;155(4):615-622. doi:10.1016/j.surg.2013.12.026
• 23. Venara A, Carretier V, Lebigot J, Lermite E. Technique and indications of percutaneous cholecystostomy in the management of cholecystitis in 2014. Journal of Visceral Surgery. 2014;151(6):435-439. doi:10.1016/j.jviscsurg.2014.06.003
• 24. Gulaya K, Desai SS, Sato K. Percutaneous Cholecystostomy: Evidence-Based Current Clinical Practice. Semin Intervent Radiol. 2016;33(4):291-296. doi:10.1055/s-0036-1592326
• 25. Saad WEA, Wallace MJ, Wojak JC, Kundu S, Cardella JF. Quality improvement guidelines for percutaneous transhepatic cholangiography, biliary drainage, and percutaneous cholecystostomy. J Vasc Interv Radiol. 2010;21(6):789-795. doi:10.1016/j.jvir.2010.01.012
• 26. Joseph T, Unver K, Hwang GL, Rosenberg J, Sze DY, Hashimi S, et al. Percutaneous cholecystostomy for acute cholecystitis: ten-year experience. J Vasc Interv Radiol. 2012;23(1):83-88.e1. doi:10.1016/j.jvir.2011.09.030
• 27. Dewhurst C, Kane RA, Mhuircheartaigh JN, Brook O, Sun M, Siewert B. Complication rate of ultrasound-guided percutaneous cholecystostomy in patients with coagulopathy. AJR Am J Roentgenol. 2012;199(6):W753-760. doi:10.2214/AJR.11.8445
• 28. Winbladh A, Gullstrand P, Svanvik J, Sandström P. Systematic review of cholecystostomy as a treatment option in acute cholecystitis. HPB (Oxford). 2009;11(3):183-193. doi:10.1111/j.1477-2574.2009.00052.x
• 29. Melloul E, Denys A, Demartines N, Calmes JM, Schäfer M. Percutaneous drainage versus emergency cholecystectomy for the treatment of acute cholecystitis in critically ill patients: does it matter? World J Surg. 2011;35(4):826-833. doi:10.1007/s00268-011-0985-y
• 30. Hasbahceci M, Cengiz MB, Malya FU, Kunduz E, Memmi N. The impact of a percutaneous cholecystostomy catheter in situ until the time of cholecystectomy on the development of recurrent acute cholecystitis: a historical cohort study. Rev Esp Enferm Dig. 2018;110(10):629-633. doi:10.17235/reed.2018.5644/2018
• 31. Sosna J, Kruskal JB, Copel L, Goldberg SN, Kane RA. US-guided percutaneous cholecystostomy: features predicting culture-positive bile and clinical outcome. Radiology. 2004;230(3):785-791. doi:10.1148/radiol.2303030121
• 32. Kaya C, Bozkurt E, Ömeroğlu S, Yazıcı P, İdiz UO, Tabakçı ÖN, et al. Is Interval Cholecystectomy Necessary After Percutaneous Cholecystostomy in High-Risk Acute Cholecystitis Patients? Sisli Etfal Hastan Tip Bul. 2018;52(1):13-18. doi:10.14744/SEMB.2018.30092
• 33. Viste A, Jensen D, Angelsen JH, Hoem D. Percutaneous cholecystostomy in acute cholecystitis; a retrospective analysis of a large series of 104 patients. BMC Surg. 2015;15:17. doi:10.1186/s12893-015-0002-8
• 34. Yildirim M, Yildirim UM, Özyer U. Akut kolesistit tedavisinde perkütan kolesistostomi: 10-yıllık tek merkez deneyimi. Cukurova Medical Journal. 2017;42(3):465-469. doi:10.17826/cutf.323830
• 35. Noh SY, Gwon DI, Ko GY, Yoon HK, Sung KB. Role of percutaneous cholecystostomy for acute acalculous cholecystitis: clinical outcomes of 271 patients. Eur Radiol. 2018;28(4):1449-1455. doi:10.1007/s00330-017-5112-5