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Invited Critique
May 2012

Cholecystectomy or Percutaneous Cholecystostomy for Acute Cholecystitis: Is It Any Clearer Which to Choose?Comment on ”Revisiting Percutaneous Cholecystostomy for Acute Cholecystitis Based on a 10-Year Experience“

Author Affiliations

Author Affiliation: Department of Surgery, Hartford Hospital and University of Connecticut School of Medicine, Hartford.

Arch Surg. 2012;147(5):422. doi:10.1001/archsurg.2012.466

Percutaneous cholecystostomy (PC) under ultrasonographic guidance was first introduced in 1979,1 yet it is not clear in what circumstances the technique is preferred over cholecystectomy. Percutaneous cholecystostomy has been used in higher-risk, often elderly and critically ill patients. As a result, reports comparing the percutaneous technique with cholecystectomy have shared a retrospective study design and have not evaluated comparable groups. Abi-Haidar et al,2 in this issue of the Archives, describe a 10-year cohort of patients who underwent both techniques. As in other studies, the PC patients were older, had higher American Society of Anesthesiologists (ASA) classification, and had more comorbidities. They experienced more readmissions and complications and had a longer hospital stay. Most patients undergoing PC ultimately required cholecystectomy, during either the index or a subsequent admission.

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