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Acute Cholecystitis in a Municipal Hospital: The Role and Results of Cholecystostomy

Acute Cholecystitis in a Municipal Hospital: The Role and Results of Cholecystostomy Abstract In debates over the virtues of delayed and early treatment for acute cholecystitis and the pros and cons of operating on the quiescent gallstone, the management of the elderly patient with acute symptoms has been given minimal attention. However, it is this patient who is being seen with increasing frequency in large municipal hospitals. Because of the high proportion of elderly patients and the relatively high incidence of acute biliary tract problems seen in this hospital, we have reviewed our surgical experience with acute cholecystitis over the past ten years. We were particularly interested in the role of cholecystostomy, and this group was reviewed in detail. A second group of patients undergoing definitive surgical procedures was also reviewed for comparison. The results are discussed in the light of previous reports from this hospital and other institutions. Case Materials The records of the San Francisco General Hospital from January 1958 to References 1. Johnson, P., and Close, M.B.: Acute Gallbladder Disease: Experience With 103 Consecutive Cases , California Med 87:291-294 ( (Nov) ) 1957. 2. Lyon, C.G., and Goldman, L.: Acute Cholecystitis in a Municipal Charity Hospital , Amer J Surg 98:283-289 ( (Aug) ) 1959.Crossref 3. Goldman, L.; Morgan, J.A.; and Kay, J.: Acute Cholecystitis: Correlation of Bacteriology and Mortality , Gastroenterology 11:318-325 ( (Sept) ) 1948. 4. Ross, F.P., and Dunphy, J.E.: Studies in Acute Cholecystitis: II. Cholecystostomy: Indications and Technic , New Eng J Med 242:359-364 ( (March 9) ) 1950.Crossref 5. Glenn, R., and Thorbjarnarson, B.: The Surgical Treatment of Acute Cholecystitis , Surg Gynec Obstet 116:61-70 ( (Jan) ) 1963. 6. Ferris, D.O., and Sterling, W.A.: Surgery of the Biliary Tract , Surg Clin N Amer 47:861-875 ( (Feb) ) 1967. 7. Glenn, F., and Hays, D.M.: The Age Factor in the Mortality Rate of Patients Undergoing Surgery of the Biliary Tract , Surg Gynec Obstet 100:11-18 ( (Jan) ) 1955. 8. Wenckert, A., and Robertson, B.: The Natural Course of Gallstone Disease: Eleven Year Review of 781 Nonoperated Cases , Gastroenterology 50:376-381 ( (March) ) 1966. 9. Becker, W.F.; Powell, J.L.; and Turner, R.J.: A Clinical Study of 1,060 Patients With Acute Cholecystitis , Surg Gynec Obstet 104:491-496 ( (April) ) 1957. 10. Ibach, J.R.; Hume, H.A.; and Erb, W.H.: Cholecystectomy in the Aged , Surg Gynec Obstet 126:523-528 ( (March) ) 1968. 11. Hinchey, E.L.; Elias, G.L.; and Hampson, L.G.: Acute Cholecystitis , Surg Gynec Osbtet 120:475-480 ( (March) ) 1965. 12. Crosby, V.G., and Ziffren, S.E.: Cholecystostomy as Definitive Therapy in the Aged With Acute Cholecystitis , J Amer Ger Soc 13:496-500 ( (June) ) 1965. 13. Rosi, P.A., and Midell, A.I.: Acute Cholecystitis: An Analysis of Current Treatment , Surg Clin N Amer 47:147-156 ( (Feb) ) 1967. 14. Gingrich, R.A., et al: Cholecystostomy in Acute Cholecystitis: Factors Influencing Morbidity and Mortality , Amer J Surg 116:310-315 ( (Aug) ) 1968.Crossref 15. Colcock, B.P.; Killen, R.B.; and Leach, N.G.: The Asymptomatic Patient With Gallstones , Amer J Surg 113:44-48 ( (Jan) ) 1967.Crossref 16. Colcock, B.P., and Perey, B.: The Treatment of Cholelithiasis , Surg Gynec Obstet 117:529-534 ( (Nov) ) 1963. 17. Dunphy, J.E., and Ross, F.P.: Studies in Acute Cholecystitis: I. Surgical Management and Results , Surgery 26:539-547 (Sept) 1949. 18. Mason, G.R.: Bacteriology and Antibiotic Selection in Biliary Tract Surgery , Arch Surg 97:533-537 ( (Oct) ) 1968.Crossref 19. Kesseler, H.J., and Reinus, F.Z.: Evaluation of the Indications for Laparotomy in Acute Cholecystitis , Amer J Surg 104:61-64 ( (July) ) 1962.Crossref http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png Archives of Surgery American Medical Association

Acute Cholecystitis in a Municipal Hospital: The Role and Results of Cholecystostomy

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Publisher
American Medical Association
Copyright
Copyright © 1969 American Medical Association. All Rights Reserved.
ISSN
0004-0010
eISSN
1538-3644
DOI
10.1001/archsurg.1969.01340100067007
Publisher site
See Article on Publisher Site

Abstract

Abstract In debates over the virtues of delayed and early treatment for acute cholecystitis and the pros and cons of operating on the quiescent gallstone, the management of the elderly patient with acute symptoms has been given minimal attention. However, it is this patient who is being seen with increasing frequency in large municipal hospitals. Because of the high proportion of elderly patients and the relatively high incidence of acute biliary tract problems seen in this hospital, we have reviewed our surgical experience with acute cholecystitis over the past ten years. We were particularly interested in the role of cholecystostomy, and this group was reviewed in detail. A second group of patients undergoing definitive surgical procedures was also reviewed for comparison. The results are discussed in the light of previous reports from this hospital and other institutions. Case Materials The records of the San Francisco General Hospital from January 1958 to References 1. Johnson, P., and Close, M.B.: Acute Gallbladder Disease: Experience With 103 Consecutive Cases , California Med 87:291-294 ( (Nov) ) 1957. 2. Lyon, C.G., and Goldman, L.: Acute Cholecystitis in a Municipal Charity Hospital , Amer J Surg 98:283-289 ( (Aug) ) 1959.Crossref 3. Goldman, L.; Morgan, J.A.; and Kay, J.: Acute Cholecystitis: Correlation of Bacteriology and Mortality , Gastroenterology 11:318-325 ( (Sept) ) 1948. 4. Ross, F.P., and Dunphy, J.E.: Studies in Acute Cholecystitis: II. Cholecystostomy: Indications and Technic , New Eng J Med 242:359-364 ( (March 9) ) 1950.Crossref 5. Glenn, R., and Thorbjarnarson, B.: The Surgical Treatment of Acute Cholecystitis , Surg Gynec Obstet 116:61-70 ( (Jan) ) 1963. 6. Ferris, D.O., and Sterling, W.A.: Surgery of the Biliary Tract , Surg Clin N Amer 47:861-875 ( (Feb) ) 1967. 7. Glenn, F., and Hays, D.M.: The Age Factor in the Mortality Rate of Patients Undergoing Surgery of the Biliary Tract , Surg Gynec Obstet 100:11-18 ( (Jan) ) 1955. 8. Wenckert, A., and Robertson, B.: The Natural Course of Gallstone Disease: Eleven Year Review of 781 Nonoperated Cases , Gastroenterology 50:376-381 ( (March) ) 1966. 9. Becker, W.F.; Powell, J.L.; and Turner, R.J.: A Clinical Study of 1,060 Patients With Acute Cholecystitis , Surg Gynec Obstet 104:491-496 ( (April) ) 1957. 10. Ibach, J.R.; Hume, H.A.; and Erb, W.H.: Cholecystectomy in the Aged , Surg Gynec Obstet 126:523-528 ( (March) ) 1968. 11. Hinchey, E.L.; Elias, G.L.; and Hampson, L.G.: Acute Cholecystitis , Surg Gynec Osbtet 120:475-480 ( (March) ) 1965. 12. Crosby, V.G., and Ziffren, S.E.: Cholecystostomy as Definitive Therapy in the Aged With Acute Cholecystitis , J Amer Ger Soc 13:496-500 ( (June) ) 1965. 13. Rosi, P.A., and Midell, A.I.: Acute Cholecystitis: An Analysis of Current Treatment , Surg Clin N Amer 47:147-156 ( (Feb) ) 1967. 14. Gingrich, R.A., et al: Cholecystostomy in Acute Cholecystitis: Factors Influencing Morbidity and Mortality , Amer J Surg 116:310-315 ( (Aug) ) 1968.Crossref 15. Colcock, B.P.; Killen, R.B.; and Leach, N.G.: The Asymptomatic Patient With Gallstones , Amer J Surg 113:44-48 ( (Jan) ) 1967.Crossref 16. Colcock, B.P., and Perey, B.: The Treatment of Cholelithiasis , Surg Gynec Obstet 117:529-534 ( (Nov) ) 1963. 17. Dunphy, J.E., and Ross, F.P.: Studies in Acute Cholecystitis: I. Surgical Management and Results , Surgery 26:539-547 (Sept) 1949. 18. Mason, G.R.: Bacteriology and Antibiotic Selection in Biliary Tract Surgery , Arch Surg 97:533-537 ( (Oct) ) 1968.Crossref 19. Kesseler, H.J., and Reinus, F.Z.: Evaluation of the Indications for Laparotomy in Acute Cholecystitis , Amer J Surg 104:61-64 ( (July) ) 1962.Crossref

Journal

Archives of SurgeryAmerican Medical Association

Published: Apr 1, 1969

References