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Percutaneous cholecystostomy: An update for the 2020s.

Hakki Muammer Karakas1, Gulsah Yildirim1, Mehmet Mahir Fersahoglu2

  • 1Department of Radiology, University of Health Sciences, Istanbul Fatih Sultan Mehmet Training and Research Hospital, Istanbul, Turkey.

Northern Clinics of Istanbul
|December 15, 2021
PubMed
Summary

Percutaneous cholecystostomy (PC) offers a life-saving alternative for acute cholecystitis in high-risk patients when surgery is too dangerous. This procedure can provide significant short-term improvement and may even be a definitive treatment.

Keywords:
Cholecystitischolecystostomygallbladderinterventional procedure

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Area of Science:

  • Interventional Radiology
  • Gastroenterology
  • Emergency Medicine

Background:

  • Cholecystectomy is the standard treatment for acute cholecystitis.
  • High-risk patients (elderly, comorbid conditions) face significant surgical risks.
  • Percutaneous cholecystostomy (PC) emerges as a critical alternative for these patients.

Purpose of the Study:

  • To review percutaneous cholecystostomy (PC) in acute cholecystitis.
  • To detail pre-procedural evaluation, risk assessment, and procedural steps for PC.
  • To highlight PC's role in high-risk surgical patients.

Main Methods:

  • Review of extensive clinical experience with PC.
  • Analysis of current medical literature on PC for acute cholecystitis.
  • Detailed presentation of pre-procedural assessment and procedural techniques.

Main Results:

  • Percutaneous cholecystostomy (PC) is a viable option with no absolute contraindications in life-threatening cases.
  • PC is often performed under urgent, rapid, and sometimes suboptimal conditions due to patient risk factors.
  • Properly conducted PC leads to significant short-term clinical improvement.

Conclusions:

  • Percutaneous cholecystostomy (PC) is life-saving for elderly patients and those with comorbid diseases or high surgical risk.
  • PC can serve as the definitive treatment for acute cholecystitis in select high-risk individuals.
  • The procedure offers significant clinical benefits when performed appropriately.