Our Summary

This research paper is about a study conducted to determine the best treatment for a type of gallbladder inflammation (acute acalculous cholecystitis) that occurs without the presence of gallstones. The researchers reviewed scientific works from 2000 to 2016, focusing on two treatments: cholecystectomy (surgical removal of the gallbladder) and percutaneous cholecystostomy (a less invasive procedure involving the insertion of a tube to drain the gallbladder).

Out of over a thousand articles, they selected ten for review. Unfortunately, none of these articles were from high-quality, randomized studies. The review suggests that percutaneous cholecystostomy might be a suitable definitive treatment for this condition, without the need for a later elective cholecystectomy. However, patients with a low risk for surgery might benefit from cholecystectomy.

The researchers conclude that percutaneous cholecystostomy could be the first choice for treatment, except in severe cases like perforation or gangrene of the gallbladder. But because the studies they reviewed are not of high quality, these recommendations should be taken with a grain of salt.

FAQs

  1. What are the two treatments for acute acalculous cholecystitis that the researchers focused on?
  2. What was the conclusion of the researchers regarding the preferred treatment for acute acalculous cholecystitis?
  3. Why should the recommendations made in this research paper be taken with caution?

Doctor’s Tip

A helpful tip a doctor might tell a patient about cholecystectomy is to discuss the risks and benefits of the surgery with their healthcare provider. They should also ask about alternative treatments and make an informed decision based on their individual situation and preferences. Additionally, patients should follow their doctor’s post-operative instructions carefully to ensure a smooth recovery.

Suitable For

Patients who are typically recommended cholecystectomy include those with acute acalculous cholecystitis who are at low risk for surgery and do not have severe complications such as perforation or gangrene of the gallbladder. These patients may benefit from cholecystectomy as a definitive treatment option. However, percutaneous cholecystostomy may also be considered as a first choice for treatment in some cases, especially in those who are not suitable candidates for surgery.

Timeline

Before cholecystectomy:

  • Patient experiences symptoms of gallbladder inflammation, such as abdominal pain, nausea, and vomiting
  • Diagnostic tests are performed to confirm the diagnosis, such as ultrasound or CT scan
  • Treatment options are discussed with the patient, including cholecystectomy or percutaneous cholecystostomy
  • Decision is made to proceed with cholecystectomy

After cholecystectomy:

  • Surgery is performed to remove the gallbladder
  • Patient is monitored in the hospital for a few days post-surgery
  • Patient may experience some pain and discomfort, but this should improve over time
  • Patient is advised on post-operative care, such as diet and activity restrictions
  • Follow-up appointments are scheduled to monitor recovery and address any concerns

Overall, the timeline for a patient before and after cholecystectomy involves a period of symptoms and diagnostic tests leading up to the surgery, followed by a recovery period post-surgery. The choice between cholecystectomy and percutaneous cholecystostomy depends on the individual patient’s condition and risk factors.

What to Ask Your Doctor

  1. What are the risks and benefits of cholecystectomy compared to percutaneous cholecystostomy for treating acute acalculous cholecystitis?
  2. How will my recovery time differ between cholecystectomy and percutaneous cholecystostomy?
  3. Are there any long-term implications of choosing one treatment over the other?
  4. What is the success rate of each treatment option in terms of resolving the inflammation and preventing future episodes?
  5. Are there any specific factors about my condition that make me a better candidate for one treatment over the other?
  6. How will my quality of life be impacted by choosing cholecystectomy versus percutaneous cholecystostomy?
  7. How often do complications arise from each treatment option, and what are they?
  8. Will I need to make any significant lifestyle changes after undergoing either procedure?
  9. How does the cost of cholecystectomy compare to percutaneous cholecystostomy, and will insurance cover either treatment?
  10. Are there any alternative treatments or procedures that I should consider before deciding on cholecystectomy or percutaneous cholecystostomy?

Reference

Authors: Soria Aledo V, Galindo Iñíguez L, Flores Funes D, Carrasco Prats M, Aguayo Albasini JL. Journal: Rev Esp Enferm Dig. 2017 Oct;109(10):708-718. doi: 10.17235/reed.2017.4902/2017. PMID: 28776380