Acute Cholecystitis and PC Overview

False (B)

Cholecystectomy with drainage of the collection.

<p>GB wall</p> Signup and view all the answers

<p>Cholecystectomy = Procedure to remove the gallbladder Biliary peritonitis = Complication from significant bile leaks Trans-peritoneal route = Common route with iatrogenic rent risks Tractogram = Assessment of cystic duct and CBD patency</p> Signup and view all the answers

<p>Medical therapy and early cholecystectomy (B)</p> Signup and view all the answers

<p>False (B)</p> Signup and view all the answers

<p>To drain the gallbladder in patients with moderate to severe acute cholecystitis.</p> Signup and view all the answers

<p>gallstones, critical illnesses</p> Signup and view all the answers

<p>Calculous cholecystitis = Caused by gallstones Acalculous cholecystitis = No gallstones present Moderate acute cholecystitis = Grade II condition Severe acute cholecystitis = Grade III condition</p> Signup and view all the answers

<p>To drain fluid from the gallbladder (A)</p> Signup and view all the answers

<p>True (A)</p> Signup and view all the answers

<p>It helps improve patient outcomes and reduce surgical risks.</p> Signup and view all the answers

<p>ecystotomist</p> Signup and view all the answers

<p>Akhan O, Akinci D, Ozmen MN (2002) = Percutaneous cholecystostomy Sparkman RS (1967) = Cholangiography history Giger UF, Michel J-M (2006) = Risk factors for complications Duncan C et al (2016) = Cholecystostomy in the presence of ascites</p> Signup and view all the answers

<p>Very elderly patients with acute cholecystitis (B)</p> Signup and view all the answers

<p>Intensive care unit with acalculous acute cholecystitis (A)</p> Signup and view all the answers

<p>Prolonged stay in ICU due to poly-trauma (C)</p> Signup and view all the answers

<p>By causing severe dehydration and prolonged total parenteral nutrition (B)</p> Signup and view all the answers

<p>Neurological diseases in elderly patients (A)</p> Signup and view all the answers

<p>Up to 50% (C)</p> Signup and view all the answers

<p>Pericholecystic fluid (D)</p> Signup and view all the answers

<p>Cholangitis and biliary obstruction (C)</p> Signup and view all the answers

<p>Image-guided cholecystostomy (D)</p> Signup and view all the answers

<p>It is relatively new and technically challenging. (C)</p> Signup and view all the answers

<p>To ensure adequate distension of the gallbladder (B)</p> Signup and view all the answers

<p>Percutaneous cholecystogram (A)</p> Signup and view all the answers

<p>Narrow or tortuous cystic duct (D)</p> Signup and view all the answers

<p>Coagulopathy or diffuse liver diseases (A)</p> Signup and view all the answers

<p>Coagulopathy (B)</p> Signup and view all the answers

<p>Immediate chest tube placement (A)</p> Signup and view all the answers

<p>Biliary pleural fistula (D)</p> Signup and view all the answers

<p>Fulminant peritonitis (B)</p> Signup and view all the answers

<p>3.6% (D)</p> Signup and view all the answers

<p>Pericatheter skin excoriation (A)</p> Signup and view all the answers

Inflammation of the gallbladder (GB), often caused by gallstones or critical illness.

Image-guided drainage of the gallbladder, often used when surgery is not feasible for severe acute cholecystitis.

Solid material that forms in the gallbladder and can lead to cholecystitis.

Inflammation of the gallbladder WITHOUT gallstones, often linked to critical illness or prolonged ICU stays.

Surgical removal of the gallbladder.

An abnormal connection between the gallbladder and the skin, often caused by a complication of percutaneous cholecystectomy (PC).

A collection of pus in the bile ducts, often a complication of acute cholecystitis.

Inflammation of the peritoneum (lining of the abdominal cavity) caused by a leak of bile.

An imaging study that maps the path of the bile ducts to identify any leaks or blockages.

It can lead to persistent biliary leakage after the PC catheter is removed because the fistula provides a direct pathway for bile to leak out.

A minimally invasive surgical procedure that involves removing the gallbladder through small incisions using a laparoscope (a viewing instrument with a camera).

A large database that tracks outcomes of laparoscopic and thoracoscopic surgeries, including cholecystectomy. This database is used to study risk factors and complications associated with these procedures.

PC is preferred in cases where surgery is too risky or impossible due to patient's condition, such as severe acute cholecystitis with complications.

Percutaneous cholecystostomy (PC) is now widely accepted as a safe and effective treatment option for complicated acute cholecystitis.

Acute cholecystitis (inflammation of the gallbladder) can be triggered by factors like gallstones, critical illness, prolonged mechanical ventilation, dehydration, sepsis, and increased inflammatory cytokines.

Diagnosing acute cholecystitis can be challenging, especially in critically ill patients, as symptoms can be masked or mimicked by their underlying condition. This makes it difficult to differentiate cholecystitis from other medical problems.

PTGBD is a procedure that involves inserting a drainage tube directly into the gallbladder through the liver, guided by ultrasound. It's used to drain bile and relieve pressure in the gallbladder, mainly when surgery is too risky.

PTGBD is used in cases of complicated acute cholecystitis, especially in patients with severe illness, where surgery is not feasible. It can also be used for other gallbladder issues, such as cholangitis and obstruction.

Endoscopic ultrasound-guided transmural gallbladder drainage (EUS-GBD) is a relatively new, technically challenging procedure used to drain the gallbladder. It's performed by skilled endoscopists and is gaining popularity for its minimally invasive nature.

Percutaneous Cholecystostomy (PC) can be done if a patient with acute cholecystitis doesn't improve with antibiotics, pain meds, and anti-inflammatories after 3 days.

PC is a good option for elderly patients with acute cholecystitis, especially if they have other health problems like heart or brain issues.

PC can be used to treat acute cholecystitis in the ICU because it's a less risky procedure than surgery in critically ill patients.

People with severe injuries (trauma) are more likely to get acute cholecystitis, so PC might be used right away.

Severe burns can also cause cholecystitis, especially if the patient needs long-term intravenous feeding and is dehydrated.

A cystic duct that is open and allows bile to flow freely from the gallbladder to the common bile duct.

An imaging test used to visualize the gallbladder and cystic duct by injecting contrast dye directly into the gallbladder.

A route for accessing the gallbladder through a puncture made directly through the liver.

A route for accessing the gallbladder through a puncture made through the abdominal wall.

The transhepatic route is often preferred for percutaneous cholecystostomy due to its better anchoring of the catheter, reduced risk of bile leakage, and faster tract maturation due to fibrin deposition in the liver.

An abnormal connection between the bile ducts and the lung lining, typically a complication of percutaneous cholecystectomy (PC).

A condition characterized by air and bile in the space between the lung and chest wall.

A build-up of pus in the space between the lung and chest wall.

A hole in the intestine, a rare complication of PC caused by a needle piercing the bowel wall.