Percutaneous cholecystostomy as a definitive treatment for moderate and severe acute acalculous cholecystitis: a retrospective observational study

Abstract

Background In this study, we aimed to investigate risk factors for the relapse of moderate and severe acute acalculous cholecystitis (AAC) patients after initial percutaneous cholecystostomy (PC) and to identify the predictors of patient outcomes when choosing PC as a definitive treatment for AAC. Materials and methods The study population comprised 44 patients (median age 76 years; range 31–94 years) with moderate or severe AAC who underwent PC without subsequent cholecystectomy. According to the results of follow-up (followed for a median period of 17 months), the data of patients with recurrence versus no recurrence were compared. Patients were divided into the death and non-death groups based on patient status within 60 days after PC. Results Twenty-one (47.7%) had no recurrence of cholecystitis during the follow-up period after catheter removal (61–1348 days), six (13.6%) experienced recurrence of cholecystitis after PC, and 17 (38.6%) patients died during the indwelling tube period (5–60 days). The multivariate analysis showed that coronary heart disease (CHD) or congestive heart failure (odds ratio [OR] 26.50; 95% confidence interval [CI] 1.21–582.06; P = 0.038) was positively correlated with recurrence. The age-adjusted Charlson comorbidity index (OR 1.53; 95% CI 1.08–2.17; P = 0.018) was independently associated with 60-day mortality after PC. Conclusions Our results suggest that CHD or congestive heart failure was an independent risk factor for relapse in moderate and severe AAC patients after initial PC. AAC patients with more comorbidities had worse outcomes.

Percutaneous Cholecystostomy in Severe Acute Cholecystitis: An Observational Study From a Single Institute

“…PC in high-surgical-risk patients with AC could be a definitive treatment [16,17]. The limitations of this study include its retrospective design and some factors or variables that may not be investigated that were the reasons for the difference in outcomes.…”

Percutaneous Cholecystostomy to Manage a Hot Gallbladder: A Single Center Experience

“…Many studies in the past have highlighted the importance of PC in high-risk and frail patients, presenting it as the only effective treatment for settling acute or recurrent AC attacks in that population [ 20 ]. However, there has been a rise in using PC to manage even younger patients with severe attacks of AC, and its use is gaining more acceptance [ 21 ]. Additionally, a large American group study also concluded that PC provided superior results in managing severe attacks of AC in comorbid patients.…”

Value of nonenhanced CT combined with laboratory examinations in the diagnosis of acute suppurative cholecystitis treated with percutaneous cholecystostomy: a retrospective study

“…The electronic medical database of our institution was searched for records of 316 AC patients who underwent PC for the first time between January 1, 2017, and June 30, 2021. The diagnosis of AC was based on clinical symptoms and signs (fever, abdominal pain, positive sonographic Murphy’s sign, or elevated inflammatory markers, such as white blood cells) and radiologic studies by abdominal US (ultrasonography), CT and so on [ 11 ]. Patients with concurrent or secondary pancreatitis (n = 41) and pancreatic trauma (n = 1) were excluded.…”

“…The gallbladder contents were aspirated via a 10-mL needle. Then, a 0.035-inch guidewire was inserted, followed by placement of an 8-Fr pigtail catheter [ 11 ]. The characteristics of the bile were observed during PC.…”