Volkan ÇAKIR, Ömür BALLI

Akut Taşlı Kolesistiti Olan Yaşlı Hastalarda Perkütan Kolesistostomi

Amaç: Akut taşlı kolesistiti (ATK) olan yaşlı hastalarda, perkütan kolesistostominin (PK) etkinliğini, güvenilirliğini, rekürrens oranlarını ve yenidengirişim ihtiyacını araştırmaktır.Gereç ve Yöntem: Ağustos 2013 ile Nisan 2017 tarihleri arasında ATK tanısı alan ve kliniğimizde PK işlemi yapılan 65 yaş üstü hastaların verilerihastane kayıt sistemi taranarak incelenmiştir.Bulgular: Toplam 53 ATK hastasına PK işlemi yapılmıştır. Hastaların 49 (%92,4) tanesi 48-72 saat içerisinde klinik olarak rahatlamıştır. PK işlemine bağlı30 günlük mortalite oranı %7,5 olarak gerçekleşmiştir. 2 (%3,8) hastada işlem sonrası pnömoni gelişmiş, 4 (%7,5) hastada ise kateter dislokasyonuolmuştur. Hastaların 17 (%32) tanesine elektif kolesistektomi, 8 (%15) tanesine de acil kolesistektomi yapılmıştır.Sonuç: PK işlemi ATK’sı bulunan, yüksek riskli yaşlı hastalarda efektif bir tedavi yöntemidir. Acil bir durumdan, elektif cerrahiye geçişte köprü görevigörebilir.

Percutaneous Cholecystostomy for Acute Calculous Cholecystitis in Elderly Patients

Objectives: To investigate the efficacy, safety, recurrence and reintervention rates of percutaneous cholecystostomy (PC) in elderly patients with acute calculous cholecystitis (ACC). Materials and Methods: The data of the patients over 65 years of age who were diagnosed with ACC and between August 2013 and April 2017 were obtained by means of the hospital registry system. Results: A total of 53 ACC patients were treated with PC. 49 (92.4%) of the patients were clinically relieved within 48-72 hours. The 30-day mortality rate associated with PC was 7.5%. 2 (3.8%) patients had postoperative pneumonia and 4 (7.5%) patients had catheter dislocation. Seventeen (32%) patients underwent elective cholecystectomy and 8 (15%) patients underwent emergency cholecystectomy. Conclusion: PC is an effective treatment in high risk elderly patients. It can act as a “bridge treatment” from an emergency to elective surgery.

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