Evidence map›Paper›PMID 32266452›Full record

ArticleWorld journal of surgery2020

Retrospective Analysis of Outcomes Following Percutaneous Cholecystostomy for Acute Cholecystitis.

L L Kuan, T Oyebola, A Mavilakandy, A R Dennison, G Garcea

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Article in World journal of surgery, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed
0.8field-weighted citation impact, top 25% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

3 citing papers in PubMed, 10 citations in OpenAlex.

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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

5 authors at 2 institutions in 2 countries.

L L KuanDepartment of Hepatobiliary and Pancreatic Surgery, University Hospitals of Leicester, NHS Trust, Gwendolen Road, Leicester, LE5 4PW, United Kingdom. kuan.lilian@gmail.com.
T OyebolaDepartment of Hepatobiliary and Pancreatic Surgery, University Hospitals of Leicester, NHS Trust, Gwendolen Road, Leicester, LE5 4PW, United Kingdom.
A MavilakandyDepartment of Hepatobiliary and Pancreatic Surgery, University Hospitals of Leicester, NHS Trust, Gwendolen Road, Leicester, LE5 4PW, United Kingdom.
A R DennisonDepartment of Hepatobiliary and Pancreatic Surgery, University Hospitals of Leicester, NHS Trust, Gwendolen Road, Leicester, LE5 4PW, United Kingdom.
G GarceaDepartment of Hepatobiliary and Pancreatic Surgery, University Hospitals of Leicester, NHS Trust, Gwendolen Road, Leicester, LE5 4PW, United Kingdom.
Leicester General Hospital · GBQueen Elizabeth Hospital · AU

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundPercutaneous cholecystostomy (PC) is often performed for patients with acute cholecystitis who are too high risk for cholecystectomy. The purpose of this retrospective study was to evaluate the outcomes of this cohort of patients over a 5-year period.

methodsA retrospective analysis of all patients treated with PC for acute cholecystitis in a tertiary centre teaching hospital was conducted. The study period ranged from January 2010 to December 2015. Clinical data were extracted from the hospitals' electronic database system, as well as reviewing clinical notes and imaging reports. The aims of this study were to detect the reason PC was undertaken as opposed to surgery, the subsequent definitive management of patients initially treated with PC, the incidence of common bile duct stones (CBDS), the complications from PC, and the 30-day mortality.

resultsA total of 96 patients were identified. The total number of patients with CBDS was 27 (28.1%). Fourteen (14.6%) patients were shown to have CBDS on initial imaging. CBDS was detected in 12 patients (12.5%) at cholangiogram during their PC procedure. One patient had CBDS detected during a check cholangiogram at 6 weeks, which was not seen on initial imaging. Twenty-eight patients (29.2%) underwent an endoscopic retrograde cholangiopancreatography (ERCP), during their index admission. The main reasons for PC were a high American Society of Anaesthesiologists (ASA) score (49%), sepsis requiring organ support (19.8%), empyema of the gallbladder (29.1%), failed external biliary drainage for biliary obstruction (2.1%), and concomitant palliative malignancy (5.2%). Interval cholecystectomy was performed in 24 patients (25%). The total 30-day in-hospital mortality was 16.7%.

conclusionPC is an effective and safe alternative as salvage therapy in high-risk elderly patients who have multiple comorbidities. It is valuable as a temporising measure before definitive treatment in high-risk patients. A high index of suspicion for CBDS (and further imaging with MRCP or a check cholangiogram) is warranted to detect missed CBDS. This is particularly relevant in this vulnerable group of patients where CBDS may represent a future source of recurrent sepsis.

Indexed as

AgedAged, 80 and overCholangiographyCholangiopancreatography, Endoscopic RetrogradeCholecystectomyCholecystitis, AcuteCholecystostomyComorbidityDrainageFemaleGallstonesHospitals, TeachingHumansMaleMiddle AgedRetrospective Studies

Identifiers

PMID32266452
OpenAlexW3014665219

What OpenQuestion holds

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.