TY - JOUR
T1 - Emergent cholecystectomy is superior to percutaneous cholecystostomy tube placement in critically ill patients with emergent calculous cholecystitis
AU - Hall, Bradley R.
AU - Armijo, Priscila R.
AU - Krause, Crystal
AU - Burnett, Tyler
AU - Oleynikov, Dmitry
N1 - Funding Information:
Funding for this study was provided by the Center for Advanced Surgical Technology at the University of Nebraska Medical Center and the Foundation for Surgical Fellows.
Funding Information:
Funding for this study was provided by the Center for Advanced Surgical Technology at the University of Nebraska Medical Center and the Foundation for Surgical Fellows .
Publisher Copyright:
© 2017 Elsevier Inc.
PY - 2018/7
Y1 - 2018/7
N2 - Background: The role of percutaneous cholecystostomy (PC) is undefined in patients with multiple comorbidities presenting with emergent calculous cholecystitis (CC). This study compared outcomes between PC, laparoscopic (LC), and open cholecystectomy (OC). Methods: The Vizient UHC database was queried for high-risk patients with CC who underwent PC, LC, OC, or laparoscopic converted to open cholecystectomy (CONV). Demographics, outcomes, mortality, length of stay (LOS), and direct cost were compared between the groups. Results: LC was the most common approach with the lowest risk of death, complications, LOS, and cost. Complication risk was highest in OC. Nearly 20% of patients underwent PC. Complication rate, LOS, infection, aspiration pneumonia, and mortality were higher in PC. Direct cost was lowest in LC, followed by CONV, PC, and OC. Conclusions: Emergent cholecystectomy for CC in high-risk patients is safer and more cost effective than PC and this study supports the use of cholecystectomy as the primary treatment approach in these patients.
AB - Background: The role of percutaneous cholecystostomy (PC) is undefined in patients with multiple comorbidities presenting with emergent calculous cholecystitis (CC). This study compared outcomes between PC, laparoscopic (LC), and open cholecystectomy (OC). Methods: The Vizient UHC database was queried for high-risk patients with CC who underwent PC, LC, OC, or laparoscopic converted to open cholecystectomy (CONV). Demographics, outcomes, mortality, length of stay (LOS), and direct cost were compared between the groups. Results: LC was the most common approach with the lowest risk of death, complications, LOS, and cost. Complication risk was highest in OC. Nearly 20% of patients underwent PC. Complication rate, LOS, infection, aspiration pneumonia, and mortality were higher in PC. Direct cost was lowest in LC, followed by CONV, PC, and OC. Conclusions: Emergent cholecystectomy for CC in high-risk patients is safer and more cost effective than PC and this study supports the use of cholecystectomy as the primary treatment approach in these patients.
KW - Cholecystectomy
KW - Cholecystitis
KW - Cholecystostomy
KW - Cost
KW - Outcomes
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U2 - 10.1016/j.amjsurg.2017.11.002
DO - 10.1016/j.amjsurg.2017.11.002
M3 - Article
C2 - 29128102
AN - SCOPUS:85034455290
VL - 216
SP - 116
EP - 119
JO - American Journal of Surgery
JF - American Journal of Surgery
SN - 0002-9610
IS - 1
ER -