A 10-Year Study on Percutaneous Cholecystostomy for Acute Cholecystitis at a Tertiary Referral Hospital

TL;DR

A 10-year study found that percutaneous cholecystostomy is a safe and effective treatment for high-risk patients with acute cholecystitis.

Contribution

A long-term evaluation of percutaneous cholecystostomy outcomes in high-risk patients with acute cholecystitis.

Findings

Percutaneous cholecystostomy had a low mortality rate (5.3%) and no deaths related to the procedure.

Sepsis on admission was identified as an independent risk factor for in-hospital mortality.

Most patients (61.2%) had PC as definitive treatment without needing further surgery.

Abstract

Background: Percutaneous cholecystostomy (PC) is an effective, minimally invasive treatment for patients with acute cholecystitis (AC) who are at high surgical risk and may be used as a bridge to surgery in critically ill patients. This study aimed to evaluate the safety of PC in patients with AC over a 10-year period. Methods: Patients who underwent PC for AC at our institution between January 2013 and May 2023 were included. Patients were categorised into the definitive and bridging PC groups. Clinical characteristics, procedure-related complications, recurrence, and overall survival were analysed. Statistical analyses were used to identify in-hospital mortality-related risk factors. Results: A total of 449 patients were included, and 89.5% had an ASA score ≥ 3. The median time to PC was 1 day, and 17.6% of patients required ICU admission. Drainage tube-related complications occurred in 37 (8.2%) patients. The median drainage and hospital stay durations were 9 (IQR 6–14) and 12 (IQR 9–15) days, respectively. During follow-up, recurrent AC was observed in 34 (7.6%), with a median time to recurrence of 63 (IQR 29–312) days. PC was the definitive treatment in 275 (61.2%) patients. The overall mortality rate was 5.3% (n = 24), with no deaths related to the drainage procedure. Sepsis on admission was an independent risk factor related to in-hospital mortality. Conclusions: Our findings confirmed that PC is a safe and effective treatment alternative for managing AC in high-risk patients with low complication and mortality rates.

Figures