Percutaneous Cholecystostomy for Treatment of Acute Cholecystitis in the Era of Early Laparoscopic Cholecystectomy

Abstract

PC can be performed safely in patients considered unfit for surgery at presentation. Outcomes are similar in patients with or without gallstones. Hypotension and absence of common bile duct filling on initial cholangiography are markers of decreased long-term survival. A significant number of patients require subsequent definitive cholecystectomy.

Outcomes of percutaneous cholecystostomy and predictors of eventual cholecystectomy

“…We had 100% technical success with PC in our institution, with minimal post-procedure complications. Our in-hospital and 30-day mortality rates are comparable to recent studies [11,12,[34][35][36][37][38]. PC is currently performed as a definitive treatment for patients with prohibitive surgical risk and less than half of our patients underwent eventual cholecystectomy.…”

Admission CRP Level as an Indicator for the Need of Percutaneous Cholecystostomy in Acute Cholecystitis

“…Accordingly, these patients had significantly longer hospital stay. In contrast to other reports [18][19][20], male sex was not a predictor of cholecystitis severity or of the need for PC in our patient cohort. Time to admission did not differ between groups, implicating that the need for PC is not due to neglected inflammatory process.…”

“…Clinical presentation is also not predictive for the need for PC: although patients who underwent PC had elevated body temperature [17,20], the physical findings of localized RUQ peritonitis or palpable mass did not differ between groups. However, the retrospective design of our study which lacked standardized physical examination, prevent firm conclusions about this issue.…”

Acute cholecystitis managed in a rural surgical department

“…The impact of these factors on the early performance of PC drainage may also explain our moderately high rate of use of this approach when compared with other series. 24,25 The rate of conversion will affect operative times, postoperative morbidity and hospital costs with Tang and Cuschieri in a systematic review, showing older age, morbid obesity, cirrhosis, prior upper abdominal surgery and the need for emergent surgery to all increase the conversion risk. 26 Others have reported the same finding as in our study, namely that male gender was also associated with a higher conversion risk 7,[27][28][29] where this effect is most probably linked to a more frequent incidence of severe acute and chronic disease in men.…”