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[PMID]:29428040
[Au] Autor:Jia B; Liu K; Tan L; Jin Z; Fu Y; Liu Y
[Ti] Título:Evaluation of the Safety and Efficacy of Percutaneous Transhepatic Gallbladder Drainage Combined with Laparoscopic Cholecystectomy for Treating Acute Complicated Cholecystitis.
[So] Source:Am Surg;84(1):133-136, 2018 Jan 01.
[Is] ISSN:1555-9823
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:The rate of acute cholecystitis in patients with severe underlying diseases is currently increasing. Several studies have reported percutaneous transhepatic gallbladder drainage (PTGBD) combined with laparoscopic cholecystectomy (LC) as a safe and reliable therapeutic option in such patients. This study aimed to elucidate the optimal time interval between PTGBD and LC. In total, 65 patients with acute complicated cholecystitis from our hospital were divided into two groups, short-term LC (sLC) and postponed LC (pLC) group according to whether the procedure was performed within 5 days of gallbladder drainage or after 5 days, respectively. The complications after PTGBD, rate of conversion to open surgery, and complications and mortality after LC were compared between the groups. The sLC group showed significantly lesser operating time, blood loss, postoperative peritoneal drainage time, postoperative oral intake time, and complications compared to the pLC group (P < 0.05). Other factors such as the length of hospital stay (LOS), conversion to open cholecystectomy, and mortality were not statistically significant between the groups. Combined treatment with PTGBC and sLC showed superior outcomes compared to PTGBC and pLC for acute cholecystitis in severely ill patients, thus constituting a feasible and secure treatment option in specialized centers.
[Mh] Termos MeSH primário: Colecistectomia Laparoscópica
Colecistite Aguda/cirurgia
Drenagem
[Mh] Termos MeSH secundário: Idoso
Colecistectomia Laparoscópica/métodos
Colecistite Aguda/mortalidade
Colecistostomia/métodos
Conversão para Cirurgia Aberta
Estudos de Viabilidade
Feminino
Seres Humanos
Masculino
Meia-Idade
Duração da Cirurgia
Fatores de Risco
Resultado do Tratamento
[Pt] Tipo de publicação:COMPARATIVE STUDY; JOURNAL ARTICLE
[Em] Mês de entrada:1803
[Cu] Atualização por classe:180301
[Lr] Data última revisão:
180301
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:180212
[St] Status:MEDLINE


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[PMID]:27778253
[Au] Autor:El-Gendi A; El-Shafei M; Emara D
[Ad] Endereço:Department of Surgery, Faculty of Medicine, Alexandria University, El Sultan Hussein Street, El-Azarita, Khartom Square, Alexandria, 21131, Egypt. draelgendi@gmail.com.
[Ti] Título:Emergency Versus Delayed Cholecystectomy After Percutaneous Transhepatic Gallbladder Drainage in Grade II Acute Cholecystitis Patients.
[So] Source:J Gastrointest Surg;21(2):284-293, 2017 02.
[Is] ISSN:1873-4626
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:INTRODUCTION: In grade II acute cholecystitis patients presenting more than 72 h after onset of symptoms, we prospectively compared treatment with emergency (ELC) to delayed laparoscopic cholecystectomy performed 6 weeks after percutaneous transhepatic gallbladder drainage (PTGBD). METHODS: Four hundred ninety-five patients with acute cholecystitis were assessed for eligibility; 345 were excluded or declined to participate. One hundred fifty patients were treated after consent with either ELC or PTGBD. RESULTS: Both PTGBD and ELC were able to resolve quickly cholecystitis sepsis. ELC patients had a significantly higher conversion rate (24 vs. 2.7 %, P < 0.001), longer mean operative time (87.8 ± 33.06 vs. 38.09 ± 8.23 min, P < 0.001), higher intraoperative blood loss (41.73 ± 51.09 vs. 26.33 ± 23.86, P = 0.008), and longer duration of postoperative hospital stay (51.71 ± 49.39 vs. 10.76 ± 5.75 h, P < 0.001) than those in the PTGBD group. Postoperative complications were significantly more frequent in the ELC group (26.7 vs. 2.7 %, P < 0.001) with a significant increase in incidence (10.7 %) of bile leak (P = 0.006) compared to those in the PTGBD group. CONCLUSION(S): PTGBD and ELC are highly efficient in resolving cholecystitis sepsis. Delayed cholecystectomy after PTGBD produces better outcomes with a lower conversion rate, fewer procedure-related complications, and a shorter hospital stay than emergency cholecystectomy.
[Mh] Termos MeSH primário: Colecistectomia Laparoscópica
Colecistite Aguda/cirurgia
Colecistostomia
[Mh] Termos MeSH secundário: Adulto
Drenagem
Emergências
Feminino
Seres Humanos
Masculino
Meia-Idade
Fatores de Tempo
[Pt] Tipo de publicação:COMPARATIVE STUDY; JOURNAL ARTICLE
[Em] Mês de entrada:1801
[Cu] Atualização por classe:180102
[Lr] Data última revisão:
180102
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:161026
[St] Status:MEDLINE
[do] DOI:10.1007/s11605-016-3304-y


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[PMID]:28394748
[Au] Autor:Nitzan O; Brodsky Y; Edelstein H; Hershko D; Saliba W; Keness Y; Peretz A; Chazan B
[Ad] Endereço:1 Infectious Disease Unit, Emek Medical Center , Afula, Israel .
[Ti] Título:Microbiologic Data in Acute Cholecystitis: Ten Years' Experience from Bile Cultures Obtained during Percutaneous Cholecystostomy.
[So] Source:Surg Infect (Larchmt);18(3):345-349, 2017 Apr.
[Is] ISSN:1557-8674
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: The aim of the study was to describe the microbiology and susceptibility patterns in acute cholecystitis by examining bile culture results from patients who underwent percutaneous cholecystostomy and examine concordance with empiric treatment. PATIENTS AND METHODS: A total of 124 patients with acute cholecystitis underwent percutaneous cholecystostomy between 2003 and 2012 at Emek Medical Center, Israel. Data on bile and blood culture results, isolate susceptibility, and clinical outcomes were retrieved from patient files. RESULTS: Bile cultures obtained from 116 patients were positive in 70 (60.3%) patients. Blood cultures obtained from 77 patients were positive in 23 (31.1%). Escherichia coli was the most common isolate in 28.6% of bile cultures and 43.5% of blood cultures. The concordance between empiric treatment coverage and culture isolate susceptibility was 67.6%. In most discordant cases, the isolates were Enterobacter spp. (40.9%) and Enterococcus spp. (31.8%). Overall, the in-hospital mortality rate was 7%: 2% in patients with concordant treatment compared with 14% in patients with discordant treatment (p = 0.09). Empiric antibiotic regimens were adequate in only two-thirds of patients. CONCLUSIONS: There might be a trend for poorer outcome in patients treated with inadequate antibiotic agents, emphasizing the importance of tailoring antibiotic treatment.
[Mh] Termos MeSH primário: Antibacterianos/uso terapêutico
Bactérias/efeitos dos fármacos
Bile/microbiologia
Colecistite Aguda/microbiologia
[Mh] Termos MeSH secundário: Adulto
Idoso
Idoso de 80 Anos ou mais
Antibacterianos/farmacologia
Bactérias/classificação
Bactérias/isolamento & purificação
Colecistite Aguda/tratamento farmacológico
Colecistite Aguda/cirurgia
Colecistostomia
Feminino
Seres Humanos
Israel
Masculino
Testes de Sensibilidade Microbiana
Meia-Idade
Resultado do Tratamento
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Nm] Nome de substância:
0 (Anti-Bacterial Agents)
[Em] Mês de entrada:1704
[Cu] Atualização por classe:170417
[Lr] Data última revisão:
170417
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170411
[St] Status:MEDLINE
[do] DOI:10.1089/sur.2016.232


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[PMID]:28261768
[Au] Autor:Tolan HK; Semiz Oysu A; Basak F; Atak I; Özbagriaçik M; Özpek A; Kaskal M; Ezberci F; Bas G
[Ad] Endereço:Department of General Surgery, Ümraniye Training and Research Hospital, Istanbul-Turkey. mdkeremtolan@gmail.com.
[Ti] Título:Percutaneous cholecystostomy: A curative treatment modality forelderly and high ASA score acute cholecystitis patients.
[So] Source:Ulus Travma Acil Cerrahi Derg;23(1):34-38, 2017 Jan.
[Is] ISSN:1306-696X
[Cp] País de publicação:Turkey
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: Acute cholecystitis (AC) is a common emergency seen by general surgeons. Optimal treatment is laparoscopic cholecystectomy (LC); however, in cases where surgery cannot be performed due to high risk of morbidity and mortality, such as in elderly patients with comorbid diseases, other treatment modalities may be used. Percutaneous cholecystostomy (PC) is one alternative method to treat AC. PC can be used to provide drainage of the gall bladder and control infection. Subsequently, interval cholecystectomy can be performed when there are better conditions. Presently described is experience and results with PC in high risk, elderly patients with AC. METHODS: Medical records of all consecutive patients who underwent PC between January 2011 and January 2014 were identified. Tokyo Guidelines were used for definitive diagnosis and severity assessment of AC. Senior surgeon elected to perform PC based on higher risk-benefit ratio due to comorbidity, age, or duration of symptoms. All PC procedures were performed by the same interventional radiologist under local anesthesia with ultrasonographic guidance. RESULTS: Total of 40 PC procedures were performed during the study period. Of those, 22 (55%) were male and 18 were (45%) were female, with median age of 70.5 years (range: 52-87 years). All of the patients had American Society of Anesthesiologists classification of either 3 or 4. Success rate of PC was 100% with complication rate of 2.5% (n=1). One patient was operated on shortly after PC procedure due to bile peritonitis complication. PC drains were kept in place for 6 weeks. Total of 16 patients (40%) had surgery following removal of PC drain. In 3 (18.8%) cases, conversion from LC was required. Remaining 23 (57.5%) patients did not have subsequent operation after drain removal. No disease recurrence was observed in follow-up. CONCLUSION: When elderly patients present in emergency setting with AC and LC cannot be performed due to comorbid disease or poor general condition, PC can be performed safely. After removal of PC drain, LC may be performed with acceptable conversion rate of 18.8%.
[Mh] Termos MeSH primário: Colecistite Aguda/cirurgia
Colecistostomia
[Mh] Termos MeSH secundário: Idoso
Idoso de 80 Anos ou mais
Colecistostomia/efeitos adversos
Colecistostomia/métodos
Colecistostomia/estatística & dados numéricos
Drenagem
Feminino
Seres Humanos
Masculino
Meia-Idade
Estudos Retrospectivos
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1706
[Cu] Atualização por classe:170623
[Lr] Data última revisão:
170623
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170307
[St] Status:MEDLINE
[do] DOI:10.5505/tjtes.2016.26053


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[PMID]:28237047
[Au] Autor:Zarour S; Imam A; Kouniavsky G; Lin G; Zbar A; Mavor E
[Ad] Endereço:Department of Surgery, Kaplan Medical Center, Rehovot, Israel; School of Medicine, Hebrew University, Jerusalem, Israel. Electronic address: Shiri.fh@gmail.com.
[Ti] Título:Percutaneous cholecystostomy in the management of high-risk patients presenting with acute cholecystitis: Timing and outcome at a single institution.
[So] Source:Am J Surg;214(3):456-461, 2017 Sep.
[Is] ISSN:1879-1883
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: Cholecystectomy is the standard of care in acute cholecystitis (AC). Percutaneous cholecystostomy (PC) is an effective alternative for high-risk surgical cases. METHODS: A retrospective analysis is presented of AC patients treated with PC drainage at a single tertiary institution over a 21 month period, assessing outcome and complications. RESULTS: Of 119 patients, 103 had clinical improvement after PC insertion. There were 7 peri-procedural deaths (5.9%), all in elderly high-risk cases. Overall, 56/103 cases (54%) were definitively managed with PC drainage with 41 patients (40%) undergoing an elective cholecystectomy (75% performed laparoscopically). The timing of PC insertion did not affect AC resolution or drain-related complications, although more patients underwent an elective cholecystectomy if PC placement was delayed (>24 h after admission). CONCLUSIONS: In AC, drainage by a PC catheter is a safe and effective procedure. It may be used either as a bridge to elective cholecystectomy or in selected cases as definitive therapy.
[Mh] Termos MeSH primário: Colecistite Aguda/cirurgia
Colecistostomia
[Mh] Termos MeSH secundário: Idoso
Idoso de 80 Anos ou mais
Colecistostomia/métodos
Drenagem
Procedimentos Cirúrgicos Eletivos
Feminino
Seres Humanos
Masculino
Estudos Retrospectivos
Medição de Risco
Fatores de Tempo
Resultado do Tratamento
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1709
[Cu] Atualização por classe:170914
[Lr] Data última revisão:
170914
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:170227
[St] Status:MEDLINE


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[PMID]:28224465
[Au] Autor:Alvino DML; Fong ZV; McCarthy CJ; Velmahos G; Lillemoe KD; Mueller PR; Fagenholz PJ
[Ad] Endereço:Department of Surgery, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA.
[Ti] Título:Long-Term Outcomes Following Percutaneous Cholecystostomy Tube Placement for Treatment of Acute Calculous Cholecystitis.
[So] Source:J Gastrointest Surg;21(5):761-769, 2017 May.
[Is] ISSN:1873-4626
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:INTRODUCTION: Percutaneous cholecystostomy tube (PCT) placement is considered a safe alternative to cholecystectomy for the treatment of acute calculous cholecystitis (ACC), but data regarding long-term outcomes following PCT are limited. METHODS: We retrospectively reviewed our institutional experience of patients undergoing PCT for ACC between 1997 and 2015. Recurrent biliary events were defined as cholecystitis, cholangitis, or gallstone pancreatitis. RESULTS: PCT was placed for 288 patients with ACC. Mean age and age-adjusted Charlson comorbidity index were 72 ± 15 years and 5.3 ± 2.4, respectively. Following PCT placement, 91% of patients successfully resolved their episode of ACC. PCT dysfunction occurred in 132 patients (46%), with 80 patients (28%) requiring re-intervention, while 7% developed procedure-related complications. Interval cholecystectomy reduced the risk of recurrent biliary events to 7% from 21% (p = 0.002). Cholecystectomy was completed laparoscopically in 45% of patients receiving an interval operation vs. 22% of those undergoing urgent surgery for PCT failure or recurrent biliary event (p = 0.03). CONCLUSIONS: PCT placement is a highly successful treatment for acute calculous cholecystitis and is associated with low complication rate, but high rate of tube dysfunction requiring frequent re-intervention. Interval cholecystectomy is associated with a decreased likelihood of recurrent biliary events and increased likelihood of successful laparoscopic completion.
[Mh] Termos MeSH primário: Colecistite Aguda/cirurgia
Colecistostomia/métodos
Colelitíase/cirurgia
[Mh] Termos MeSH secundário: Idoso
Idoso de 80 Anos ou mais
Colecistectomia
Colecistite Aguda/etiologia
Colecistostomia/instrumentação
Colelitíase/complicações
Feminino
Seres Humanos
Masculino
Meia-Idade
Procedimentos Cirúrgicos Minimamente Invasivos
Recidiva
Estudos Retrospectivos
Fatores de Risco
Fatores de Tempo
Resultado do Tratamento
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1705
[Cu] Atualização por classe:171104
[Lr] Data última revisão:
171104
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170223
[St] Status:MEDLINE
[do] DOI:10.1007/s11605-017-3375-4


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[PMID]:28089036
[Au] Autor:Rodrigues-Pinto E; Grimm IS; Baron TH
[Ad] Endereço:Gastroenterology Department, Centro Hospitalar São João, Porto, Portugal.
[Ti] Título:Biliary bypass redux: lessons for the therapeutic endoscopist from the archives of surgery.
[So] Source:Gastrointest Endosc;85(2):428-432, 2017 Feb.
[Is] ISSN:1097-6779
[Cp] País de publicação:United States
[La] Idioma:eng
[Mh] Termos MeSH primário: Procedimentos Cirúrgicos do Sistema Biliar/métodos
Colestase/cirurgia
Endoscopia do Sistema Digestório/métodos
Stents Metálicos Autoexpansíveis
[Mh] Termos MeSH secundário: Anastomose Cirúrgica
Colecistostomia
Coledocostomia
Duodenostomia
Gastrostomia
Seres Humanos
Jejunostomia
[Pt] Tipo de publicação:EDITORIAL
[Em] Mês de entrada:1709
[Cu] Atualização por classe:170918
[Lr] Data última revisão:
170918
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170117
[St] Status:MEDLINE


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[PMID]:28071951
[Au] Autor:Hariharan D; Lobo DN
[Ad] Endereço:Gastrointestinal Surgery, National Institute for Health Research Nottingham Digestive Diseases Biomedical Research Unit, Nottingham University Hospitals and University of Nottingham, Queen's Medical Centre , Nottingham , UK.
[Ti] Título:Spontaneous extrusion of gallstones after percutaneous drainage.
[So] Source:Ann R Coll Surg Engl;99(3):e1-e2, 2017 Mar.
[Is] ISSN:1478-7083
[Cp] País de publicação:England
[La] Idioma:eng
[Ab] Resumo:There have been reports of late discharge of gallstones through operative wounds after spillage into the peritoneal cavity during laparoscopic cholecystectomy and after the development of spontaneous cholecystocutaneous fistulae. However, spontaneous discharge of gallstones from the tract of a percutaneous cholecystostomy or percutaneous drainage of a perforated gall bladder has not, to the best of our knowledge, been reported previously. We report a case in which a patient who had a percutaneous drain inserted for a perforated gall bladder discharged 34 gallstones from the tract after removal of the 7-F pigtail catheter.
[Mh] Termos MeSH primário: Fístula Biliar
Fístula Cutânea
Cálculos Biliares/diagnóstico por imagem
Complicações Pós-Operatórias
[Mh] Termos MeSH secundário: Idoso de 80 Anos ou mais
Colecistostomia
Drenagem
Feminino
Doenças da Vesícula Biliar/diagnóstico por imagem
Doenças da Vesícula Biliar/cirurgia
Cálculos Biliares/cirurgia
Seres Humanos
Tomografia Computadorizada por Raios X
[Pt] Tipo de publicação:CASE REPORTS; JOURNAL ARTICLE
[Em] Mês de entrada:1704
[Cu] Atualização por classe:170615
[Lr] Data última revisão:
170615
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170111
[St] Status:MEDLINE
[do] DOI:10.1308/rcsann.2017.0015


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[PMID]:28069529
[Au] Autor:Dimou FM; Adhikari D; Mehta HB; Riall TS
[Ad] Endereço:Department of Surgery, The University of Texas Medical Branch, Galveston, TX; Department of Surgery, University of South Florida, Tampa, FL.
[Ti] Título:Outcomes in Older Patients with Grade III Cholecystitis and Cholecystostomy Tube Placement: A Propensity Score Analysis.
[So] Source:J Am Coll Surg;224(4):502-511.e1, 2017 Apr.
[Is] ISSN:1879-1190
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: The Tokyo Guidelines recommend initial cholecystostomy tube drainage, antibiotics, and delayed cholecystectomy in patients with grade III cholecystitis. STUDY DESIGN: We used Medicare data (1996 to 2010) to identify patients 66 years and older who were admitted with grade III acute cholecystitis. We evaluated adherence to the Tokyo Guidelines and compared mortality, readmission, and complication rates with and without cholecystostomy tube placement in a propensity-matched (1:3) cohort of patients with grade III cholecystitis. RESULTS: There were 8,818 patients admitted with grade III cholecystitis; 565 patients (6.4%) had a cholecystostomy tube placed. Cholecystostomy tube placement increased from 3.9% to 9.7% during the study period. Compared with 1,689 propensity-matched controls, patients with cholecystostomy tube placement had higher 30-day (hazard ratio [HR] = 1.26; 95% CI 1.05 to 1.50), 90-day (HR = 1.26; 95% CI 1.08 to 1.46), and 2-year mortality (HR = 1.19; 95% CI 1.04 to 1.36) and were less likely to undergo cholecystectomy in the 2 years after initial hospitalization (33.4% vs 64.4%; HR = 0.26; 95% CI 0.21 to 0.31). Readmissions were also higher at 30 days (HR = 2.93; 95% CI 2.12 to 4.05), 90 days (HR = 3.48; 95% CI 2.60 to 4.64), and 2 years (HR = 3.08; 95% CI 2.87 to 4.90). CONCLUSIONS: Since the introduction of the Tokyo Guidelines (2007), use of cholecystostomy tubes in patients with grade III cholecystitis has increased, but the majority of patients do not get cholecystostomy tube drainage as first-line therapy. Cholecystostomy tube placement was associated with lower rates of definitive treatment with cholecystectomy, higher mortality, and higher readmission rates. These data suggest a need for additional evaluation and refinement of the Tokyo Guidelines.
[Mh] Termos MeSH primário: Colecistite Aguda/cirurgia
Colecistostomia/utilização
Fidelidade a Diretrizes/tendências
Padrões de Prática Médica/estatística & dados numéricos
[Mh] Termos MeSH secundário: Fatores Etários
Idoso
Idoso de 80 Anos ou mais
Colecistite Aguda/mortalidade
Colecistite Aguda/patologia
Colecistostomia/normas
Colecistostomia/estatística & dados numéricos
Colecistostomia/tendências
Feminino
Fidelidade a Diretrizes/estatística & dados numéricos
Seres Humanos
Masculino
Readmissão do Paciente/estatística & dados numéricos
Complicações Pós-Operatórias/epidemiologia
Guias de Prática Clínica como Assunto
Pontuação de Propensão
Estudos Retrospectivos
Índice de Gravidade de Doença
Resultado do Tratamento
Estados Unidos
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1708
[Cu] Atualização por classe:170809
[Lr] Data última revisão:
170809
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:170111
[St] Status:MEDLINE


  10 / 622 MEDLINE  
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[PMID]:28050668
[Au] Autor:Loftus TJ; Brakenridge SC; Dessaigne CG; Sarosi GA; Zingarelli WJ; Moore FA; Jordan JR; Croft CA; Smith RS; Efron PA; Mohr AM
[Ad] Endereço:Department of Surgery, University of Florida, 1600 SW Archer Road, PO Box 100108, Gainesville, FL, 32610, USA.
[Ti] Título:Antibiotics May be Safely Discontinued Within One Week of Percutaneous Cholecystostomy.
[So] Source:World J Surg;41(5):1239-1245, 2017 May.
[Is] ISSN:1432-2323
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: For patients with acute cholecystitis managed with percutaneous cholecystostomy (PC), the optimal duration of post-procedural antibiotic therapy is unknown. Our objective was to compare short versus long courses of antibiotics with the hypothesis that patients with persistent signs of systemic inflammation 72 h following PC would receive prolonged antibiotic therapy and that antibiotic duration would not affect outcomes. METHODS: We performed a retrospective cohort analysis of 81 patients who underwent PC for acute cholecystitis at two hospitals during a 41-month period ending November 2014. Patients who received short (≤7 day) courses of post-procedural antibiotics were compared to patients who received long (>7 day) courses. Treatment response to PC was evaluated by systemic inflammatory response syndrome (SIRS) criteria. Logistic and linear regressions were used to evaluate associations between antibiotic duration and outcomes. RESULTS: Patients who received short (n = 30) and long courses (n = 51) of antibiotics had similar age, comorbidities, severity of cholecystitis, pre-procedural vital signs, treatment response, and culture results. There were no differences in recurrent cholecystitis (13 vs. 12%), requirement for open/converted to open cholecystectomy (23 vs. 22%), or 1-year mortality (20 vs. 18%). On logistic and linear regressions, antibiotic duration as a continuous variable was not predictive of any salient outcomes. CONCLUSIONS: Patients who received short and long courses of post-PC antibiotics had similar baseline characteristics and outcomes. Antibiotic duration did not predict recurrent cholecystitis, interval open cholecystectomy, or mortality. These findings suggest that antibiotics may be safely discontinued within one week of uncomplicated PC.
[Mh] Termos MeSH primário: Antibacterianos/administração & dosagem
Colecistectomia
Colecistite Aguda/cirurgia
Colecistostomia
[Mh] Termos MeSH secundário: Idoso
Colecistectomia/efeitos adversos
Colecistectomia/métodos
Colecistostomia/efeitos adversos
Colecistostomia/métodos
Esquema de Medicação
Feminino
Seres Humanos
Masculino
Complicações Pós-Operatórias/diagnóstico
Estudos Retrospectivos
Síndrome de Resposta Inflamatória Sistêmica/diagnóstico
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Nm] Nome de substância:
0 (Anti-Bacterial Agents)
[Em] Mês de entrada:1706
[Cu] Atualização por classe:170601
[Lr] Data última revisão:
170601
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170105
[St] Status:MEDLINE
[do] DOI:10.1007/s00268-016-3861-y



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