Cholecystostomy Treatment in an ICU Population: Complications and Risks.

Area of Science:

• Interventional Radiology
• Critical Care Medicine
• Surgical Outcomes

Background:

• Percutaneous cholecystostomy tube placement is a common alternative to cholecystectomy for critically ill patients.
• Reported complication rates for this procedure have varied widely.
• The safety of this intervention in intensive care unit (ICU) settings requires further evaluation.

Purpose of the Study:

• To assess the safety and complication rates associated with percutaneous cholecystostomy tube placement in critically ill patients.
• To identify specific complications and their impact on patient outcomes.

Main Methods:

• Retrospective analysis of 96 critically ill patients who underwent percutaneous cholecystostomy tube placement between 2005 and 2010.
• Evaluation of complications occurring within 72 hours of the procedure and those related to the tube's presence.
• Data collected from a tertiary care center in central Massachusetts.

Main Results:

• The overall complication rate was 69% (66 out of 96 patients).
• Tube dislodgment was the most frequent complication, with 34 episodes.
• Fifty-four complications were directly related to the procedure or tube presence; 67 occurred within 72 hours.
• Ten patients died, with severe complications potentially contributing to mortality.

Conclusions:

• Percutaneous cholecystostomy tube placement is associated with a high incidence of complications, particularly tube dislodgment.
• These complications can lead to significant morbidity and mortality in the ICU population.
• Underreporting of complication rates may be an issue, and the impact of this procedure in critically ill patients should not be underestimated.