Related Experiment Video
Updated: Oct 10, 2025
A Two-Step Method for Percutaneous Transhepatic Choledochoscopic Lithotomy
Published on: September 13, 2022
When to remove the drainage catheter in patients with percutaneous cholecystostomy?
Sevcan Alkan Kayaoglu1, Metin Tilki1
1Haydarpasa Numune Training and Research Hospital, Department of General Surgery - Istanbul, Turkey.
Insights
Percutaneous cholecystostomy is a safe alternative for high-risk acute calculous cholecystitis patients. Leaving the catheter for at least 21 days reduces recurrence rates.
Area of Science:
- Gastroenterology
- Interventional Radiology
- Surgical Innovation
Background:
- Acute calculous cholecystitis poses risks for high-surgical-risk patients.
- Percutaneous cholecystostomy offers a less invasive treatment option.
- Optimal catheter duration for percutaneous cholecystostomy remains undetermined.
Purpose of the Study:
- To evaluate the efficacy and safety of percutaneous cholecystostomy for acute calculous cholecystitis.
- To determine the optimal duration for percutaneous cholecystostomy catheter placement.
- To share clinical experience with this intervention.
Main Methods:
- Retrospective review of 163 patients with acute calculous cholecystitis treated with percutaneous cholecystostomy (Jan 2011-Jul 2020).
- Diagnosis and grading based on Tokyo Guidelines 2018.
- Analysis of catheter duration, complications, and outcomes.
Main Results:
- Mean patient age was 71.8 years; 143 had grade 2 and 20 had grade 3 disease.
- Mean catheter duration was 39.12 days; 6.9% experienced complications (catheter dislocation most common).
- 33.1% underwent cholecystectomy; recurrence rate was 5.5%, mortality 1.8%.
Conclusions:
- Recurrence rates were significantly higher with catheter duration <21 days.
- A minimum catheter duration of 21 days is recommended for percutaneous cholecystostomy.
- Percutaneous cholecystostomy is a viable alternative for high-risk patients.
Objective:
The treatment for patients with acute calculous cholecystitis who have high surgical risk with percutaneous cholecystostomy instead of surgery is an appropriate alternative choice. The aim of this study was to examine the promising percutaneous cholecystostomy intervention to share our experiences about the duration of catheter that has yet to be determined.
Methods:
A total of 163 patients diagnosed with acute calculous cholecystitis and treated with percutaneous cholecystostomy between January 2011 and July 2020 were reviewed retrospectively. The Tokyo Guidelines 2018 were used to diagnose and grade patients with acute cholecystitis.
Results:
The mean age was 71.81±12.81 years. According to the Tokyo grading, 143 patients had grade 2 and 20 patients had grade 3 disease. The mean duration of catheter was 39.12±37 (1-270) days. Minimal bile leakage into the peritoneum was noted in 3 (1.8%) patients during the procedure. The rate of complications during follow-up of the patients who underwent percutaneous cholecystostomy was 6.9% (n=11), and the most common complication was catheter dislocation. Cholecystectomy was performed in 33.1% (n=54) of the patients at follow-up. Post-cholecystectomy complication rate was 12.9%. At the follow-up, the rate of recurrent acute cholecystitis episodes was 5.5%, while the mortality rate was 1.8%. The length of follow-up was five years.
Conclusions:
The rate of recurrence was significantly higher among the patients with catheter for <21 days. We recommend that the duration of catheter should be minimum 21 days in patients undergoing percutaneous cholecystostomy.
Related Concept Videos
01:26Cardiac Catheterization IV: Nursing Management
01:29Appendicitis-II: Diagnostic Studies and Management
Diagnosing Appendicitis
It requires a multifaceted approach, starting with a detailed physical examination to pinpoint the location and nature of the pain and identify any associated symptoms. Laboratory tests play a crucial role. A complete Blood Count (CBC) typically reveals leukocytosis (an increased number of...
01:29Suctioning the Nasopharyngeal Airway
Equipment Required
01:22Aneurysm IV: Nursing Management
01:23Tracheostomy Suctioning II: Procedure
01:27Parentral Nutrition: Centeral and Peripheral Parental Nutrition
PN can be administered through two primary routes:
1. Central Parenteral Nutrition (CPN):
CPN involves delivering a high concentration of nutrients through a large vein. This is typically achieved using a Peripherally Inserted Central Catheter (PICC) or,...