Percutaneous Cholecystostomy for Acute Cholecystitis: A Three-Year Single-Centre Experience Including During COVID-19

Area of Science:

• Medical Interventions
• Surgical Procedures
• Gastroenterology

Background:

• Percutaneous cholecystostomy is a recognized treatment for acute cholecystitis, traditionally for non-surgical candidates.
• The COVID-19 pandemic increased cholecystostomy utilization due to surgical disruptions.
• Optimal timing for interval cholecystectomy after percutaneous cholecystostomy remains unclear.

Purpose of the Study:

• To evaluate the practice of percutaneous cholecystostomy and subsequent interval cholecystectomy over a three-year period.
• To analyze the time interval between procedures, associated complications, and patient outcomes.
• To provide evidence-based recommendations on the timing of interval cholecystectomy.

Main Methods:

• Retrospective analysis of patients undergoing percutaneous cholecystostomy between January 1, 2018, and January 1, 2021.
• Primary outcome: time to cholecystectomy.
• Secondary outcomes: cholecystostomy/cholecystectomy complications, 30-day mortality, and postoperative hospital stay.

Main Results:

• 31 patients were included; 13 (42%) underwent interval laparoscopic cholecystectomy.
• Median time from cholecystostomy to cholecystectomy was 97 days (IQR: 81-140).
• Cholecystostomy complications occurred in 13% (n=4); 30-day mortality was 0%. One small bowel perforation occurred 106 days post-procedure.

Conclusions:

• Percutaneous cholecystostomy is a safe and effective treatment for acute cholecystitis.
• Careful consideration of interval cholecystectomy timing is necessary.
• Performing interval cholecystectomy before 90 days may be associated with improved safety.