SURGICAL MANAGEMENT OF ACUTE CALCULUS CHOLECYSTOPATHY ΙΝ ΤΗΕ ELDRERLΥ ''HIGH-RISK" ΡΑΤΙΕΝΤ
Abstract
In this study we present the management of 56 elderly high-risk patients with acute cholecystopathy (acute cholecystitis, empyema). 40 of these patients were managed conservatively and 16 with surgical procedures: 9 underwent cholecystectomy under local anesthesia, 3 underwent cholecystostomy under ultrasonographic or CT scanninig quidance. Our results were satisfactory. We had 14 deaths (25%) and 8 recurrences. Ιn conclusion we belive that the ideal surgical procedure for acute cholecystitis is cholecystectomy. However in the elderly high-risk patients cholecystostomy or tube cholecystostomy under CT scanninig or ultrasonographic quidance has its own indications.References
Glenn F.: Cholecystostomy in the high risk patient with biliary tract disease. Ann Surg 185: 185-191, 1977
Gingrich RA, Awe WC, Boyden ΑΜ et al.: Cholecystostomy in acute cholecystitis: factors influencing morbidity and mortality. Am J Surg 116: 310-315, 1968.
Klimberg S, Hawkins I, Vogel SB.: Percutaneous cholecystostomy for acute cholecystitis in high-risk patients. Am J Surg 153: 125-129, 1987.
Morrow DJ, Wilson SE.: Acute cholecystitis in the elderly: asurgical emergency. Arch Surg. 113:1149, 1978.
Wright ΗΚ, Holden WD.: The risks of emergency surgery for acute cholecystitis: Arch Surg, 81:341, 1960.
Gagic Ν, Fry CF: The results of cholecystostomy for the treatment of acute cholecystitis. Surg Gynecol Obstet 140: 255-257, 1975.
