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Published on: November 25, 2025
Outcomes of percutaneous cholecystostomy and predictors of eventual cholecystectomy
Charleen Shan Wen Yeo1, Vivyan Wei Yen Tay2, Jee Keem Low1
1Department of General Surgery, Tan Tock Seng Hospital, 11 Jalan Tan Tock Seng, Singapore 308433.
Insights
Percutaneous cholecystostomy (PC) is a safe and effective treatment for acute cholecystitis in high-risk patients. Prompt PC improves survival, while comorbidity severity predicts mortality and influences the likelihood of eventual cholecystectomy.
Area of Science:
- Gastroenterology
- Interventional Radiology
- Surgical Oncology
Background:
- Percutaneous cholecystostomy (PC) is a key intervention for acute cholecystitis in patients unsuitable for surgery.
- This study investigates predictors of mortality and subsequent cholecystectomy following PC.
Purpose of the Study:
- To identify factors associated with mortality after percutaneous cholecystostomy.
- To determine predictors of eventual cholecystectomy in patients treated with PC.
Main Methods:
- Retrospective review of 103 patients undergoing PC between March 2005 and March 2015.
- Analysis of patient demographics, clinical data, comorbidities (APACHE II, Charlson Comorbidity Index), and procedural details.
- Outcomes assessed included length of stay, complications, readmission rates, mortality, and rates of eventual cholecystectomy.
Main Results:
- Higher APACHE II scores, Charlson Comorbidity Index (CCI), and longer intervals from diagnosis to PC correlated with in-hospital mortality.
- Younger age, lower APACHE II scores, and lower CCI were associated with undergoing eventual cholecystectomy.
- The 30-day mortality rate was 10.7%, with 41% of patients proceeding to cholecystectomy.
Conclusions:
- Percutaneous cholecystostomy is a safe and effective treatment for acute cholecystitis, particularly in high-risk surgical candidates.
- Timely PC intervention enhances survival rates for high-risk patients.
- Comorbidity severity is a significant determinant of mortality and influences the decision for subsequent cholecystectomy.
Background:
Percutaneous cholecystostomy (PC) is an established treatment for high surgical risk patients with acute cholecystitis. This paper studies factors predictive of mortality and eventual cholecystectomy.
Methods:
A retrospective review of all patients who underwent PC from March 2005 to March 2015 was performed. Patient demographics, clinical features, comorbidity profile, grade of cholecystitis, interval between cholecystitis diagnosis and PC, and method of PC were studied. Length of stay, complications, readmission rate, mortality and eventual cholecystectomy were studied. For patients with eventual cholecystectomy, operative data and perioperative outcomes were studied.
Results:
One hundred and three patients with median age of 80 years (range 43-105) underwent PC. Median interval to PC was 2 days (range 0-15). 9.7% of patients had complications. Median length of stay was 19 days (range 3-206). 41% underwent eventual cholecystectomy. 30-day mortality rate was 10.7%. Higher APACHE II scores (P = 0.004), higher Charlson comorbidity index (CCI) (P = 0.009), and longer interval from diagnosis to PC (P = 0.037) were associated with in-hospital mortality. Younger age (P = 0.015), lower APACHE II scores (P = 0.043) and lower CCI (P = 0.002) were associated with eventual cholecystectomy.
Conclusion:
Percutaneous cholecystostomy is safe and effective in treatment of acute cholecystitis. Prompt PC improves survival in high risk surgical patients. Comorbidity severity is associated with mortality. Patients with lesser comorbidity are likely to receive eventual cholecystectomy.
