0
We're unable to sign you in at this time. Please try again in a few minutes.
Retry
We were able to sign you in, but your subscription(s) could not be found. Please try again in a few minutes.
Retry
There may be a problem with your account. Please contact the AMA Service Center to resolve this issue.
Contact the AMA Service Center:
Telephone: 1 (800) 262-2350 or 1 (312) 670-7827  *   Email: subscriptions@jamanetwork.com
Error Message ......
Invited Critique |

Invited Critique: Effective Use of Percutaneous Cholecystostomy in High-Risk Surgical Patients

David L. Nahrwold, MD
Arch Surg. 1999;134(7):732. doi:10.1001/archsurg.134.7.732.
Text Size: A A A
Published online

Extract

Surgeons have sought to reduce the mortality and morbidity of gallstone disease since Bobbs performed the first cholecystostomy in 1867. The highest death rates are in patients with acute cholecystitis who are sick from other diseases or are recovering from major surgical procedures. Percutaneous cholecystostomy is advocated in these patients to avoid the risks of general anesthesia and the trauma of a major procedure. The authors' results are similar to those reported by others; they show that acute cholecystitis in high-risk surgical patients is a devastating problem. Approximately 41% of patients died in the first 2 months, and of those who survived, 3 still have cholecystostomy drains, 2 had cholecystectomy, 1 needs cholecystectomy, 1 required endoscopic retrograde cholangiopancreatography, and 1 has an asymptomatic stone. Only 5 patients, 23% of the entire group, had no biliary problems after percutaneous cholecystostomy. Unlike cholecystectomy, percutaneous cholecystostomy does not cure most patients of biliary tract disease.

Sign in

Create a free personal account to sign up for alerts, share articles, and more.

Purchase Options

• Buy this article
• Subscribe to the journal

First Page Preview

View Large
First page PDF preview

First Page Preview

View Large
First page PDF preview

Figures

Tables

References

Correspondence

CME
Also Meets CME requirements for:
Browse CME for all U.S. States
Accreditation Information
The American Medical Association is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians. The AMA designates this journal-based CME activity for a maximum of 1 AMA PRA Category 1 CreditTM per course. Physicians should claim only the credit commensurate with the extent of their participation in the activity. Physicians who complete the CME course and score at least 80% correct on the quiz are eligible for AMA PRA Category 1 CreditTM.
Note: You must get at least of the answers correct to pass this quiz.
Your answers have been saved for later.
You have not filled in all the answers to complete this quiz
The following questions were not answered:
Sorry, you have unsuccessfully completed this CME quiz with a score of
The following questions were not answered correctly:
Commitment to Change (optional):
Indicate what change(s) you will implement in your practice, if any, based on this CME course.
Your quiz results:
The filled radio buttons indicate your responses. The preferred responses are highlighted
For CME Course: A Proposed Model for Initial Assessment and Management of Acute Heart Failure Syndromes
Indicate what changes(s) you will implement in your practice, if any, based on this CME course.
Submit a Comment

Multimedia

Some tools below are only available to our subscribers or users with an online account.

Sign in

Create a free personal account to sign up for alerts, share articles, and more.

Purchase Options

• Buy this article
• Subscribe to the journal

Related Content

Customize your page view by dragging & repositioning the boxes below.

See Also...
Articles Related By Topic
Related Collections
PubMed Articles
Jobs
brightcove.createExperiences();