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Percutaneous cholecystostomy is a definitive treatment for acute cholecystitis in elderly high-risk patients

Min Li1, Ning Li, Wu Ji

  • 1Department of General Surgery, Jinling Hospital, Nanjing University School of Medicine, Nanjing, Jiangshu Province, China.

The American Surgeon
|May 3, 2013
PubMed

Insights

Percutaneous cholecystostomy (PC) offers a safe and effective treatment for acute cholecystitis (AC) in high-risk elderly patients. This study suggests PC alone is sufficient, obviating the need for subsequent cholecystectomy.

Area of Science:

  • Gastroenterology
  • Interventional Radiology
  • Geriatric Medicine

Background:

  • Acute cholecystitis (AC) in elderly, high-risk patients presents treatment challenges.
  • Percutaneous cholecystostomy (PC) is an alternative to emergency cholecystectomy with lower risks.
  • The necessity of cholecystectomy after PC in this population remains debated.

Purpose of the Study:

  • To evaluate the safety and efficacy of percutaneous cholecystostomy (PC) as a definitive treatment for acute cholecystitis (AC) in elderly, high-risk patients.
  • To assess the long-term outcomes, including recurrence rates and survival, of AC patients treated solely with PC.
  • To determine if cholecystectomy is necessary following successful PC in this specific patient group.

Main Methods:

  • Retrospective review of medical records of elderly, high-risk AC patients who underwent PC.
  • Analysis of symptom resolution, drainage-related complications, and mortality rates post-PC.
  • Evaluation of long-term outcomes including cholecystitis recurrence and patient survival rates.

Main Results:

  • PC effectively resolved AC symptoms in 98.6% of patients.
  • Drainage-related morbidity and mortality were low (4.1% and 1.4%, respectively).
  • No patients required subsequent cholecystectomy; cholecystitis recurrence was 4.1%. One-year and three-year survival rates were 82.2% and 39.7%.

Conclusions:

  • Percutaneous cholecystostomy (PC) can be considered a definitive treatment for acute cholecystitis (AC) in elderly, high-risk patients.
  • Cholecystectomy is not routinely necessary after successful PC, given the low recurrence rates and limited survival.
  • PC offers a safe and effective management strategy, improving outcomes for high-risk AC patients.

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