Long-Term Results of Percutaneous Cholecystostomy for Definitive Treatment of Acute Acalculous Cholecystitis : A 10-Year Single-Center Experience

Abstract

Background and study aims : Conventional use of percutaneous cholecystostomy [PC] is bridging therapy todelayed cholecystectomy for acute cholecystitis in high-surgical risk patients. Primary aim of this report is to evaluate the long-term outcome of PC as a definitive treatment for acute acalculous cholecystitis [AAC].

Patients and methods : Seventy-one AAC patients who underwent PC procedure were identified. Fifty-one interventions in 47 patients who were treated only with PC and followed-up after catheter withdrawal were reviewed to evaluate the long-term efficacy of PC as a definitive treatment for AAC.

Results : Technical and short-term clinical success rates were 100% ) and 92%, respectively. In-hospital mortality rate was 9.3%, minor complication rate was 5.3%, major complication rate was 2.7% and procedure related mortality was 0%. Median follow-up after catheter withdrawal was 8 months. Long-term primary clinical success after removal of the catheter was 87.2%. With the repeated PC in 4 of 6 recurrences, clinical success was 95.7%. Presence of bile sludge, perforation or a co-existing disease did not result in a significant difference in recurrence free survival.

Conclusions : PC was a safe and easy to perform procedure with high positive clinical response and low long-term recurrence rate. PC without subsequent cholecystectomy may be a favorable treatment for AAC with respect to high surgical risk present in most of the AAC patients.