Comparison of early outcome from transperitoneal versus transhepatic percutaneous cholecystostomy

To determine whether there is a statistically significant difference in the short-term clinical outcome in patients undergoing percutaneous cholecystostomy based on the anatomic route of gallbladder puncture that is, transhepatic versus transperitoneal.

Our population consisted of 132 patients who: 1) presented with acute cholecystitis, 2) were at high risk for surgery because of comorbid conditions, 3) underwent percutaneous cholecystostomy either using computed tomography guidance or ultrasound guidance and whose anatomic route was known: the transhepatic percutaneous cholecystostomy group comprised 59 patients, the transperitoneal group 73 patients. Demographic characteristics and clinical parameters of the groups were compared statistically, as were postprocedure hospital course, complications and time to hospital discharge.

The two groups were similar in demographic characteristics. There was a statistically significant tendency for computed tomography-guided percutaneous cholecystostomy to be transhepatic, and for ultrasound-guided percutaneous cholecystostomy to be transperitoneal. There were no differences in short-term postprocedure complications between the two groups. There was a tendency for shorter time to hospital discharge following transperitoneal percutaneous cholecystostomy.

Transperitoneal and transhepatic percutaneous cholecystostomy are similar in short-term safety, with no significant difference in complication rate. The interventional radiologist can feel secure in performing percutaneous cholecystostomy using either approach.