# Outcomes of Percutaneous Cholecystostomy as a Bridging or Definitive Treatment for Acute Cholecystitis

## TL;DR

Percutaneous cholecystostomy is a safe and effective treatment for acute cholecystitis in high-risk patients, with high success and low complication rates.

## Contribution

This study provides empirical evidence on the outcomes of percutaneous cholecystostomy in a real-world clinical setting.

## Key findings

- Symptom resolution occurred in 87.1% of patients who underwent percutaneous cholecystostomy.
- Mortality was 10.2% in delayed procedures but 0% in early procedures.
- Complications such as bile leakage occurred in 7.1% of cases, with no significant differences between acalculous and calculous cholecystitis.

## Abstract

Percutaneous cholecystostomy (PC) is a minimally invasive intervention for managing acute cholecystitis in patients unfit for immediate cholecystectomy. Although it is widely used, its outcomes and factors influencing clinical success are not well understood.

Objectives

The goal of this study was to assess the outcomes of PC by examining various factors such as gender, type of cholecystitis, and procedure timing to correlate with symptom improvement, mortality, and the need for additional medical interventions.

Materials and methods

A cross-sectional study was conducted at The Royal Oldham Hospital UK, from December 2019 to June 2024. A total of 70 patients who underwent PC for acute cholecystitis were included. Data on patient demographics, type of cholecystitis, timing of the procedure, duration of catheter placement, and clinical outcomes were collected and analysed using appropriate statistical tests.

Results

Seventy patients (mean age 53.70±16.48 years; catheter duration 17.70±6.73 days) were analysed. Symptom resolution occurred in 61 (87.1%) patients and failed in nine (12.9%). Among middle-aged adults, 19 (90.4%) improved versus 42 (85.7%) older adults (p=0.766). In men, 36 (90.0%) cases were resolved, whereas 25 resolved in women (83.3%) (p=0.410). Bile leakage occurred in five (7.1%) patients, of which two (9.1%) were acalculous and three (6.3%) calculous (p=0.668). Mortality occurred in two patients (10.2%) in delayed PC and none (0.0%) in early PC (p=0.05). Additional interventions occurred in 32 (45.7%) patients: four (33.3%) short-term, nine (36%) moderate term and 19 (57.5%) long-term (p=0.945). PC led to high success (87.1%), low complications (7.1%), and low mortality (10.2%).

Conclusion

PC is an effective and safe way of managing acute cholecystitis in high-risk patients, with high symptom resolution and low complication rates. Our study findings did not reveal any significant effect of procedural and patient factors on outcomes. Appropriate patients and individually tailored management strategy is the key to advise best possible outcomes and long-term management.