중심정맥용 수액관을 이용한 경피적 담낭조루술

Abstract

Purpose: Percutaneous cholecystostomy (PC) using a pig-tail catheter is indicated for high risk acute cholecystitis. However, this procedure is time consuming, expensive and requires radiological equipment. This study compared PC using a pig-tail catheter with central venous catheterization set. Methods: From January 1992 to June 2003, 44 patients underwent PC without a malignancy or a combined hepato- biliary-pancreatic disease were selected. A retrospective study was performed on the time interval to procedure, cost, complications and therapeutic results of the central venous catheter group (A, 15) and the pig-tail catheter group (B, 29). Results: The time interval was 1.8 days in group A, 3.52 in group B (p=0.002). The cost was 188,684 won in group A, 327,814 won in group B. There were 4 complications in group A (2 leakage, 1 dislodgment, 1 malfunction) while 5 in group B (2 dislodgement, 1 sepsis, 2 malfunction). Although PC, 2 in group A and 5 in group B were discharged hopelessly or died due to the progression of the underlying disease. Twenty-two patients underwent a delayed cholecystectomy with 7 patients in group A (3 laparoscopy, 4 open) and 15 in group B (6 laparoscopy, 8 open, 1 conversion to open). The complication rate was slightly high in group A but there were no statistical significance, no clinical problems and no difference in the mortality rate and surgical method. Conclusion: In high risk acute cholecystitis, PC using central venous catheter is easy, economic, effective and performed at early stage in the emergency room by medical doctors or surgeons.