Optimal timing for performing percutaneous transhepatic gallbladder drainage to severe acute cholecystitis patients who visit the emergency department

Choi, Jun Young; Ryu, Hyun Sik; Park, Seong Soo; Lee, Jae Kwang; Choi, Hyun Soo; Hwang, Seung Yeon; Jang, Ji Yeon; Lee, Se Jong; Lee, Hye Ji

J Korean Soc Emerg Med > Volume 34(1); 2023 > Article

Original Article

Journal of The Korean Society of Emergency Medicine 2023;34(1): 63-69.

중증 급성 담낭염 환자에서 응급실 내원 후 경피적 담낭배액술 시행까지의 적절한 시간

최준영

건양대학교병원 응급의학과

Optimal timing for performing percutaneous transhepatic gallbladder drainage to severe acute cholecystitis patients who visit the emergency department

Department of Emergency Medicine, Konyang University Hospital, Daejeon, Korea

Correspondence

Hyun Sik Ryu ,Tel: 042-600-9119, Fax: 042-600-9026, Email: alsiki@hanmail.net,

Received: April 27, 2022; Revised: June 24, 2022 Accepted: June 27, 2022. Published online: February 28, 2023.

ABSTRACT

Objective:
Severe acute cholecystitis is an infectious disease that requires immediate gallbladder drainage. Although percutaneous transhepatic gallbladder drainage (PTGBD) is the most common method of gallbladder drainage, the optimal timing remains unclear.
Method:
This study is a retrospective analysis of patients diagnosed with severe acute cholecystitis who underwent PTGBD between July 2018 to June 2021. This study investigated the effect of time from emergency department arrival to PTGBD (tPTGBD) on patient prognosis.
Results:
Totally, 48 patients were included in this study. Based on the cutoff value calculated using the Youden index, the group with tPTGBD of <5.93 hours had a shorter hospital stay (10 vs. 13.5 days, P=0.021), lower portion of progression (27:5 [15.6%] vs. 7:9 [56.3%], P=0.004), even they had a higher initial SOFA score (6 vs. 4.6, P=0.049). However, no statistical difference was obtained for the length of ICU stay between both groups (1 vs. 2, P=0.617).
Conclusion:
Executing PTGBD to severe acute cholecystitis patients within 5.93 hours after presenting at the emergency department is associated with reduced progression and hospital stay.

Key words: Acute cholecystitis; Organ dysfunction scores; Cholecystostomy