Percutaneous cholecystostomy is an effective definitive treatment option for acute acalculous cholecystitis.

Abstract

AIMS:

Acute acalculous cholecystitis can be treated with percutaneous cholecystostomy in critically ill patients unfit for surgery. However, the evidence on the outcome is sparse. We conducted a retrospective analysis of acute acalculous cholecystitis patients treated with percutaneous cholecystostomy during a 10-year study period.

METHODS:

An observational study of 56 consecutive patients treated with percutaneous cholecystostomy for acute acalculous cholecystitis was conducted in the period from 1 June 2002 to 31 May 2012. All data were obtained by review of medical records.

RESULTS:

A total of 56 consecutive patients were treated with percutaneous cholecystostomy for acute acalculous cholecystitis. Six patients (10.7%) died within 30 days after the procedure. Percutaneous cholecystostomy could serve as a definitive treatment option in 45 patients (80.4%), whereas 1 patient (1.8%) required cholecystectomy due to recurrence of cholecystitis. Four patients (7.1%) were treated with percutaneous cholecystostomy as a bridging procedure to subsequent elective laparoscopic cholecystectomy within a median of 8.8 months (range: 7.7-33.4 months). There was no significant difference in the risk of cholecystitis recurrence between patients with (6/37) and without (2/3) contrast passage to the duodenum on cholangiography (p = 0.096).

CONCLUSION:

Percutaneous cholecystostomy is successful as a definitive treatment option in the majority of patients with acute acalculous cholecystitis. It is associated with a low rate of mortality and subsequent cholecystectomy.

• Authors: J Kirkegård, T Horn, S D Christensen, L P Larsen, A R Knudsen, F V Mortensen
• Journal: Scandinavian journal of surgery : SJS : official organ for the Finnish Surgical Society and the Scandinavian Surgical Society (Scand J Surg) Vol. 104 Issue 4 Pg. 238-43 (Dec 2015) ISSN: 1799-7267 [Electronic] England
• PMID: 25567854 (Publication Type: Journal Article, Observational Study)
• Copyright: © The Finnish Surgical Society 2015.

Topics

• Acalculous Cholecystitis (diagnosis, mortality, surgery)
• Acute Disease
• Aged
• Aged, 80 and over
• Algorithms
• Cholangiopancreatography, Endoscopic Retrograde
• Cholangiopancreatography, Magnetic Resonance
• Cholecystectomy (methods)
• Denmark (epidemiology)
• Female
• Follow-Up Studies
• Humans
• Incidence
• Male
• Middle Aged
• Postoperative Complications (epidemiology)
• Retrospective Studies
• Survival Rate (trends)
• Time Factors
• Tomography, X-Ray Computed
• Treatment Outcome