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

Abstract

Objective A percutaneous cholecystostomy (PC) is a suitable option for treating acutely inflamed gallbladders. Its use has been postulated before for treating acute cholecystitis (AC), especially in elderly populations. The primary aim of our study is to analyze and present the positive results of PC as a bridge to laparoscopic cholecystectomy. Methods All patients who underwent PC at our hospital, Princess Royal University Hospital, King's College Hospital NHS Foundation Trust, London, GBR, from October 2020 were reviewed using a retrospective approach. Results Our study comprises 123 patients, with 72 females (58.5%) and 51 males (41.4%). In our study, many patients had significant comorbidities, and some of them were categorized as high-risk due to their frailty and medical conditions. The majority of the patients were in American Society of Anaesthesiologists' (ASA) groups II and III (45, 61), respectively. Though hospital stays can depend on variable factors, in our experience, the mean hospital length of stay was 12.7 days. In our study, 119 patients (96.8%) had the procedure through the interventional radiological approach, while only four patients had it through the laparoscopic approach. The transhepatic route for drainage was more commonly practiced at our center and was used in 108 patients. At the time of writing this article, 54 patients have already had a laparoscopic cholecystectomy (LC) done as an interval procedure after surpassing the acute attack of cholecystitis, while 42 patients are still awaiting their surgical procedure. Conclusion Our results show that PC is a viable option, especially in cases of AC that are not responding to conservative treatments. Our study has shown low complications and conversion rates after PC. We believe PC is a safe and effective tool for managing severe and refractory cases of AC.

Outcome Predictors of Percutaneous Cholecystostomy As Definitive Versus Bridging Treatment for Acute Cholecystitis

“…Of the 48 patients in total, 26 (54%) had PC as their definitive treatment and 22 (46%) had PC as bridging treatment to a delayed LC, with a median duration of 50.5 days. The bridging LC rates in the current study were similar to other studies and had a shorter duration between PC and surgery than the 116 and 144 days in those studies [ 21 , 22 ].…”

Outcomes of Percutaneous Image-Guided and Laparoscopic Cholecystostomies in High-Risk Patients With Acute Calculus Cholecystitis: A Five-Year District General Hospital Experience

“…The mean hospital stay in our study was 13.5 days, which is slightly higher than reported by Kaya et al but equivalent to the one outlined by Bhatia et al [18,19]. A total of 15 of our patients underwent planned LC after PC; 2 of them died within 30 days of the procedure, and 10 patients had PC as a definitive procedure because they were surgically very high-risk secondary to their significant comorbidities.…”