PERCUTANEOUS ASPIRATION, LAVAGE AND ANTIBIOTIC INSTILLATION
1992

New Approach in the Management of Acute Cholecystitis

Sample size: 103 publication Evidence: moderate

Author Information

Author(s): Aws S. Salim

Primary Institution: Stobhill General Hospital

Hypothesis

Can percutaneous aspiration, lavage, and antibiotic instillation improve outcomes for patients with acute cholecystitis who do not respond to conservative management?

Conclusion

The PALA procedure is effective and offers significant advantages over cholecystostomy in managing acute cholecystitis.

Supporting Evidence

  • PALA patients had no sepsis, while cholecystostomy had a 6% chest infection rate.
  • PALA allowed earlier return to eating compared to cholecystostomy.
  • PALA patients were discharged from the hospital much sooner than those who had cholecystostomy.

Takeaway

Doctors tested a new way to treat gallbladder infections that didn't get better with regular medicine, and it worked really well.

Methodology

Patients were randomized to receive either standard cholecystostomy or PALA after failing conservative treatment.

Limitations

PALA is not a definitive procedure and should be followed by elective cholecystectomy.

Participant Demographics

53 PALA patients (41 women, 12 men, mean age 36) and 50 cholecystostomy patients (40 women, 10 men, mean age 35).

Statistical Information

P-Value

p < 0.001

Statistical Significance

p < 0.001

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