Treatment with ultrasound guided percutaneous cholecystostomy in acute cholecystitis: 10-year a single-center experience

Abstract

Purpose: Evaluating the technical success, clinical outcomes and safety of ultrasound-guided percutaneous cholecystostomy (PC) in patients with acute cholecystitis.

Material and Methods: Medical records of patients diagnosed as acute cholecystitis and treated with PC from year 2000 to 2011 were retrospectively examined. ASA scores, leukocyte counts, gall stone presence, bile cultures, additional interventions, interval surgery, procedure-related complications and mortality were reviewed.

Results: PC catheters were placed in 127 patients (72 male, 55 female) aged from 31 to 100 years. Technical success of the procedure was 100%. Clinical success was obtained in 86% of the patients. No procedure related mortality or early major complications were observed. Minor complication rate was 7% (9/127) and late major complication rate was 3% (4/127). Thirty day in-hospital mortality rate was 8% (10/127). Six patients died after interval cholecystectomy and 4 patients died before the operation. PC served as a definitive treatment in 74% (17/23) of the patients with acalculous cholecystitis. Fifty-eight percent (31/53) of the patients with acute calculous cholecystitis were treated only with percutaneous cholecystostomy and only 10% (3/31) had recurrent cholecystitis in follow up.

Conclusion: PC can be preferred over primary cholecystectomy in acute cholecystitis patients. The procedure has high technical success, high clinical response and low complication rates. It can also serve as a definitive treatment option in patients with high surgical risk.