[The role of echo-guided percutaneous cholecystectomy in acute cholecystitis].

Personal experience in the treatment of acute cholecystitis with percutaneous cholecystostomy in high risk patients and in elderly patients is reported. Between January 1989 and November 1990, 28 patients affected by acute cholecystitis were treated with percutaneous cholecystostomy at Emergency Surgery Department, Verona University Hospital. The patients treated included 13 men and 15 women; 8 of them were under 70 years old, 5 between 70th and 75th and the remaining patients over 75 years old. The suspected clinical diagnosis of acute cholecystitis was confirmed in all cases by ultrasonography (accuracy 95.4%). The percutaneous cholecystostomy was successful in 26 over 28 cases. In all these cases patients had a sudden improvement of their clinical conditions. In one case we failed because the guide-wire slipped out of the gallbladder and we couldn't perform a second attempt for the patient's refuse; in an other case there was the dislodgment of the catheter after less than 12 hours from the cholecystostomy and the patient was operated on. Twenty-two of 26 patients whose conditions were improved by percutaneous cholecystostomy, subsequently underwent elective cholecystectomy. In 2 cases of acalculous cholecystitis the patients did not undergo the operation; in 2 cases because of the elderly age of the patients and their bad cardiorespiratory conditions we preferred not to perform the operation. We had not major complications; 6 patients complained pain irradiating to right shoulder which disappeared within 30-60 minutes from the end of the procedure.(ABSTRACT TRUNCATED AT 250 WORDS)