The Clinical Outcomes of the Percutaneous Cholecystostomy, Supportive Care Versus Cholecystectomy.

Acute Calculous Cholecystitis Clinical Trial

Official title:

The Percutaneous Cholecystostomy is Appropriate as the Ultimate Treatment of Acute Cholecystitis in Critically Ill Patients: a Cross-sectional Study at Single Center.

Clinical Trial Details — Status: Completed

Administrative data

• NCT number: NCT01894321
• Other study ID #: PTGBD1
• Status: Completed
• Phase: N/A
• First received: June 29, 2013
• Last updated: July 3, 2013
• Start date: January 2007
• Est. completion date: December 2012

Study information

• Verified date: July 2013
• Source: Cheju Halla General Hospital
• Contact: n/a
• Is FDA regulated: No
• Health authority: Korea: Ministry for Health and Welfare
• Study type: Observational

Clinical Trial Summary

Percutaneous cholecystostomy (PC) is an effective treatment for cholecystitis in surgical high risk patients. However, there has been no definite agreement of the additional cholecystectomy in these patients. The investigators surveyed the clinical outcomes of the PC in surgical high risk patients. And the investigators tried to prove the PC can be appropriate and ultimate treatment for acute cholecystitis patients with critical illness through this study.

Description:

Between 2007 and 2012, all patients admitted for acute cholecystitis, and then underwent ultrasonography guided percutaneous cholecystostomy in Cheju Halla General Hospital were consecutively enrolled.

Among 82 patients, 35 were performed laparoscopic cholecystectomy after recovery (Cholecystectomy group) and 47 treated by best supportive care without additional surgery (BSC group).

The investigators analyzed their surgical risks and clinical outcomes of both patients retrospectively.

Recruitment information / eligibility

• Status: Completed
• Enrollment: 82
• Est. completion date: December 2012
• Est. primary completion date: December 2012
• Accepts healthy volunteers: No
• Gender: Both
• Age group: N/A and older

Eligibility

Inclusion Criteria:

• Clinical diagnosis of acute cholecystitis

• Underwent the ultrasound-guided percutaneous cholecystostomy

Exclusion Criteria:

• Transferred patients from other institute after cholecystostomy procedure.

Study Design

Observational Model: Case Control, Time Perspective: Retrospective

Related Conditions & MeSH terms

• Acute Acalculous Cholecystitis
• Acute Calculous Cholecystitis
• Cholecystitis
• Cholecystitis, Acute

Locations

Country	Name	City	State
Korea, Republic of	Digestive disease center, Department of Internal Medicine, Cheju Halla General Hospital	Jeju-si	Jeju special self-governing province

Sponsors (1)

Lead Sponsor	Collaborator
Cheju Halla General Hospital

Country where clinical trial is conducted

Korea, Republic of, 

References & Publications (26)

Bakkaloglu H, Yanar H, Guloglu R, Taviloglu K, Tunca F, Aksoy M, Ertekin C, Poyanli A. Ultrasound guided percutaneous cholecystostomy in high-risk patients for surgical intervention. World J Gastroenterol. 2006 Nov 28;12(44):7179-82. — View Citation

Byrne MF, Suhocki P, Mitchell RM, Pappas TN, Stiffler HL, Jowell PS, Branch MS, Baillie J. Percutaneous cholecystostomy in patients with acute cholecystitis: experience of 45 patients at a US referral center. J Am Coll Surg. 2003 Aug;197(2):206-11. — View Citation

Chok KS, Chu FS, Cheung TT, Lam VW, Yuen WK, Ng KK, Chan SC, Poon RT, Yeung C, Lo CM, Fan ST. Results of percutaneous transhepatic cholecystostomy for high surgical risk patients with acute cholecystitis. ANZ J Surg. 2010 Apr;80(4):280-3. doi: 10.1111/j.1445-2197.2009.05105.x. — View Citation

Escarce JJ, Shea JA, Chen W, Qian Z, Schwartz JS. Outcomes of open cholecystectomy in the elderly: a longitudinal analysis of 21,000 cases in the prelaparoscopic era. Surgery. 1995 Feb;117(2):156-64. — View Citation

Everhart JE, Khare M, Hill M, Maurer KR. Prevalence and ethnic differences in gallbladder disease in the United States. Gastroenterology. 1999 Sep;117(3):632-9. — View Citation

Frazee RC, Nagorney DM, Mucha P Jr. Acute acalculous cholecystitis. Mayo Clin Proc. 1989 Feb;64(2):163-7. — View Citation

Granlund A, Karlson BM, Elvin A, Rasmussen I. Ultrasound-guided percutaneous cholecystostomy in high-risk surgical patients. Langenbecks Arch Surg. 2001 Apr;386(3):212-7. — View Citation

Griniatsos J, Petrou A, Pappas P, Revenas K, Karavokyros I, Michail OP, Tsigris C, Giannopoulos A, Felekouras E. Percutaneous cholecystostomy without interval cholecystectomy as definitive treatment of acute cholecystitis in elderly and critically ill patients. South Med J. 2008 Jun;101(6):586-90. doi: 10.1097/SMJ.0b013e3181757b77. — View Citation

Ha JP, Tsui KK, Tang CN, Siu WT, Fung KH, Li MK. Cholecystectomy or not after percutaneous cholecystostomy for acute calculous cholecystitis in high-risk patients. Hepatogastroenterology. 2008 Sep-Oct;55(86-87):1497-502. — View Citation

Hatzidakis AA, Prassopoulos P, Petinarakis I, Sanidas E, Chrysos E, Chalkiadakis G, Tsiftsis D, Gourtsoyiannis NC. Acute cholecystitis in high-risk patients: percutaneous cholecystostomy vs conservative treatment. Eur Radiol. 2002 Jul;12(7):1778-84. Epub 2002 Feb 21. — View Citation

Hirota M, Takada T, Kawarada Y, Nimura Y, Miura F, Hirata K, Mayumi T, Yoshida M, Strasberg S, Pitt H, Gadacz TR, de Santibanes E, Gouma DJ, Solomkin JS, Belghiti J, Neuhaus H, Büchler MW, Fan ST, Ker CG, Padbury RT, Liau KH, Hilvano SC, Belli G, Windsor JA, Dervenis C. Diagnostic criteria and severity assessment of acute cholecystitis: Tokyo Guidelines. J Hepatobiliary Pancreat Surg. 2007;14(1):78-82. Epub 2007 Jan 30. — View Citation

Houghton PW, Jenkinson LR, Donaldson LA. Cholecystectomy in the elderly: a prospective study. Br J Surg. 1985 Mar;72(3):220-2. — View Citation

Hultman CS, Herbst CA, McCall JM, Mauro MA. The efficacy of percutaneous cholecystostomy in critically ill patients. Am Surg. 1996 Apr;62(4):263-9. — View Citation

Kalliafas S, Ziegler DW, Flancbaum L, Choban PS. Acute acalculous cholecystitis: incidence, risk factors, diagnosis, and outcome. Am Surg. 1998 May;64(5):471-5. — View Citation

Kiviluoto T, Sirén J, Luukkonen P, Kivilaakso E. Randomised trial of laparoscopic versus open cholecystectomy for acute and gangrenous cholecystitis. Lancet. 1998 Jan 31;351(9099):321-5. — View Citation

Koebrugge B, van Leuken M, Ernst MF, van Munster I, Bosscha K. Percutaneous cholecystostomy in critically ill patients with a cholecystitis: a safe option. Dig Surg. 2010;27(5):417-21. doi: 10.1159/000308460. Epub 2010 Oct 15. — View Citation

Koo KP, Thirlby RC. Laparoscopic cholecystectomy in acute cholecystitis. What is the optimal timing for operation? Arch Surg. 1996 May;131(5):540-4; discussion 544-5. — View Citation

Leveau P, Andersson E, Carlgren I, Willner J, Andersson R. Percutaneous cholecystostomy: a bridge to surgery or definite management of acute cholecystitis in high-risk patients? Scand J Gastroenterol. 2008;43(5):593-6. doi: 10.1080/00365520701851673. — View Citation

Lo CM, Liu CL, Fan ST, Lai EC, Wong J. Prospective randomized study of early versus delayed laparoscopic cholecystectomy for acute cholecystitis. Ann Surg. 1998 Apr;227(4):461-7. — View Citation

Lujan JA, Parrilla P, Robles R, Marin P, Torralba JA, Garcia-Ayllon J. Laparoscopic cholecystectomy vs open cholecystectomy in the treatment of acute cholecystitis: a prospective study. Arch Surg. 1998 Feb;133(2):173-5. — View Citation

McKay A, Abulfaraj M, Lipschitz J. Short- and long-term outcomes following percutaneous cholecystostomy for acute cholecystitis in high-risk patients. Surg Endosc. 2012 May;26(5):1343-51. doi: 10.1007/s00464-011-2035-0. Epub 2011 Nov 17. — View Citation

Morse BC, Smith JB, Lawdahl RB, Roettger RH. Management of acute cholecystitis in critically ill patients: contemporary role for cholecystostomy and subsequent cholecystectomy. Am Surg. 2010 Jul;76(7):708-12. — View Citation

Oken MM, Creech RH, Tormey DC, Horton J, Davis TE, McFadden ET, Carbone PP. Toxicity and response criteria of the Eastern Cooperative Oncology Group. Am J Clin Oncol. 1982 Dec;5(6):649-55. — View Citation

Vogelzang RL, Nemcek AA Jr. Percutaneous cholecystostomy: diagnostic and therapeutic efficacy. Radiology. 1988 Jul;168(1):29-34. — View Citation

Weiss CA 3rd, Lakshman TV, Schwartz RW. Current diagnosis and treatment of cholecystitis. Curr Surg. 2002 Jan-Feb;59(1):51-4. — View Citation

Welschbillig-Meunier K, Pessaux P, Lebigot J, Lermite E, Aube Ch, Brehant O, Hamy A, Arnaud JP. Percutaneous cholecystostomy for high-risk patients with acute cholecystitis. Surg Endosc. 2005 Sep;19(9):1256-9. Epub 2005 Jul 14. — View Citation

* Note: There are 26 references in all — Click here to view all references

Outcome

Type	Measure	Description	Time frame	Safety issue
Primary	All cause mortality		within 30 days	No
Secondary	Evidence of recurrent cholecystitis or biliary complication	Acute cholecysitits : fever, abdominal pain, abnormal chemistry results Biliary complication : Gallstone pancreatitis, gallstone ileus or cholangitis	Within 30 days	No
Secondary	Evidence of recurrent cholecystitis or biliary complication	Acute cholecystits : fever, abdominal pain, abnormal chemistry results Biliary complication : Gallstone pancreatitis, gallstone ileus or cholangitis	Within 30 days	No