An Update on the Management of Acute Calculus Cholecystitis: A Review | Chapter 12 | An Overview of Disease and Health Research Vol. 1

The management of acute calculus cholecystitis has seen a change in management with the introduction of early laparoscopic cholecystectomy.  The management of high-risk patients or Tokyo Guideline grade 3, however, is an area of concern. Drainage of the gallbladder is a bridging procedure that is performed to stabilise patients to perform an interval cholecystectomy later. Percutaneous cholecystostomy is the most common drainage procedure, with endoscopic procedures like Endoscopic trans papillary gallbladder drainage and Endoscopic Ultrasound Gallbladder drainage being reserved for patients who will not undergo surgery. In this review, the role of early laparoscopic cholecystectomy, subtotal cholecystectomy, and drainage of the gallbladder in the management of acute cholecystitis is discussed.

 

Author (s) Details

Kumar H.R.
Taylor's University School of Medicine and Health Science, 47500 Selangor, Malaysia.

 

Please see the book here:- https://doi.org/10.9734/bpi/aodhr/v1/5546

 

Drainage of the Gallbladder in High-Risk Patients with Acute Cholecystitis: An Update on Management | Chapter 8 | An Overview of Disease and Health Research Vol. 1

Acute calculus cholecystitis is a very common condition, affecting 20% of all cases of symptomatic gallstone disease. Drainage of the gallbladder has been incorporated into the management of acute cholecystitis in high-risk surgical patients. This review examines various gallbladder drainage procedures, their indications, and complications in the management of acute cholecystitis in high-risk patients.

 

The Tokyo Guidelines have included drainage of the gallbladder for the management of patients in grade 3 to stabilise them and perform an interval cholecystectomy later. Percutaneous cholecystostomy is the most common drainage procedure. The procedure is easy to perform, and it is associated with minimal procedural side effects. The common problem is the care and maintenance of the tube. Endoscopic drainage procedures are often indicated for high-risk patients who would never undergo a cholecystectomy. Still, endoscopic drainage procedures have slowly emerged for drainage of the gallbladder. Endoscopic drainage includes endoscopic trans papillary gallbladder drainage (ETGBD) and endoscopic ultrasound gallbladder drainage (EUSGBD). While effective, these techniques require advanced endoscopic training and facilities, and this limits its use in resource-limited settings.

 

Author (s) Details

 

Kumar H.R.
Taylor's University School of Medicine and Health Science, 47500 Selangor, Malaysia.

 

Please see the book here:- https://doi.org/10.9734/bpi/aodhr/v1/5478