Percutaneous cholecystostomy results of 136 acute cholecystitis patients: A retrospective cohort study

Metin Yeşiltaş; Dursun Özgür Karakaş; Serkan Arıbal; Berk Gökçek; Seracettin Eğin; Semih Hot

doi:10.28982/josam.980122

Authors

Metin Yeşiltaş https://orcid.org/0000-0002-2080-1572
Dursun Özgür Karakaş https://orcid.org/0000-0002-2466-9855
Serkan Arıbal University of Health Sciences, Prof. Dr. Cemil Taşçıoğlu City Hospital, Clinic of Radiology https://orcid.org/0000-0002-0338-2652
Berk Gökçek SAĞLIK BİLİMLERİ ÜNİVERSİTESİ, İSTANBUL PROF. DR. CEMİL TAŞÇIOĞLU ŞEHİR SAĞLIK UYGULAMA VE ARAŞTIRMA MERKEZİ, CERRAHİ TIP BİLİMLERİ BÖLÜMÜ, GENEL CERRAHİ ANABİLİM DALI https://orcid.org/0000-0001-9989-4152
Seracettin Eğin SAĞLIK BİLİMLERİ ÜNİVERSİTESİ, İSTANBUL PROF. DR. CEMİL TAŞÇIOĞLU ŞEHİR SAĞLIK UYGULAMA VE ARAŞTIRMA MERKEZİ, CERRAHİ TIP BİLİMLERİ BÖLÜMÜ, GENEL CERRAHİ ANABİLİM DALI https://orcid.org/0000-0002-4090-5205
Semih Hot AĞLIK BİLİMLERİ ÜNİVERSİTESİ, İSTANBUL PROF. DR. CEMİL TAŞÇIOĞLU ŞEHİR SAĞLIK UYGULAMA VE ARAŞTIRMA MERKEZİ, CERRAHİ TIP BİLİMLERİ BÖLÜMÜ, GENEL CERRAHİ ANABİLİM DALI https://orcid.org/0000-0001-9623-356X

DOI:

https://doi.org/10.28982/josam.980122

Keywords:

Acute cholecystitis, Comorbidities, Percutaneous cholecystostomy, Recurrence

Abstract

Background/Aim: Percutaneous cholecystostomy (PC) is an alternative procedure to surgery in selected patients with acute cholecystitis (AC). This study aimed to review the clinical and surgical results of patients who underwent percutaneous cholecystostomy. Methods: The records of patients who underwent PC for AC were evaluated for age, gender, comorbidities, survey, catheterization timing, complications, control, removal timing, operation type, interval time, pathology, C-reactive protein (CRP) level and white blood cell count (WBC), ultrasonography (USG) and computed tomography (CT) results. Results: One hundred and thirty-six AC patients who underwent PC were included in the study. The median age was 73 (32-96) years and 57.3% of the patients were male. Out of the 136, 106 (78%) had an American Society of Anesthesiologists (ASA) classification score of 3 or 4. The median Charlson’s comorbidity index (CCI) score was 5 (0-13). The median timing of catheterization was 23 (20-144) hours and length of hospital stay (LOS) was 3 (1-25) days. Dislocation was the most common complication of PC, and 7.4% (n=10) had recurrent AC. The median time until tube removal was 26.5 (1-238) days. Among all, 41.2% (n=56) of the patients underwent interval cholecystectomy, which equates to 76.8% of the those performed laparoscopically. The median time until the operation was 100 (1-264) days. Chronic cholecystitis was the most common pathology of cholecystectomy after PC. Bacterial bile cultures were analyzed in 36 of the patients and showed positive results in 66.7%, with no overall effect on the outcome. Nine patients (6.6%) died. Conclusion: The importance of PC in AC increased with the Covid19 pandemic. PC was performed especially for old patients with ASA ≥3, and CCI ≥5 due to lower complication and recurrence rates. PC could be the final treatment for selected AC patients. Interval cholecystectomies performed after 8 weeks had a shorter LOS and a lower rate of complication.

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