Computed tomography-guided percutaneous cholecystostomy: a single institution's 6-year experience

High-risk surgical patients often face limited treatment options for acute gallbladder conditions. Standard care typically involves surgical removal of the gallbladder. However, patients with significant comorbidities may not tolerate surgery well. Prior research has shown that percutaneous cholecystostomy can serve as an alternative. This gap motivated a closer look at outcomes when using computed tomography guidance. No prior work had resolved whether CT-guided procedures could reliably reduce mortality in high-risk groups. Understanding the role of imaging modalities is essential for refining treatment algorithms. The need to assess procedural safety in vulnerable populations remains unmet. This paper contributes by focusing on a specific imaging-guided approach. The study addresses a critical need in emergency surgical decision-making.

The study aimed to assess the safety and outcomes of CT-guided percutaneous cholecystostomy in high-risk patients. Researchers focused on mortality rates as the primary outcome measure. They examined 7- and 30-day mortality following the procedure. The motivation stemmed from a need to evaluate non-surgical alternatives for at-risk patients. This approach could offer a safer option for those unsuitable for surgery. The study also investigated factors that might influence mortality outcomes. The goal was to determine if CT-guided PC could provide acceptable survival rates. This work contributes to the growing field of interventional emergency care.

The study reviewed medical and imaging records from a single institution over six years. Researchers included all consecutive patients who underwent CT-guided percutaneous cholecystostomy. Participants were adults with confirmed indications for the procedure. The primary outcomes were 7- and 30-day mortality rates. Secondary variables included ICU admission and other clinical parameters. Data collection focused on patients deemed high surgical risk. The analysis included 86 patients with various gallbladder pathologies. The study design allowed for a detailed review of procedural outcomes.

The 7-day mortality rate was 16.3% among the 86 patients studied. The 30-day mortality rate rose to 22.1%. ICU admission was significantly associated with higher mortality (P<0.05). Age, sex, diagnosis, and catheter size did not show significant associations. The most common diagnosis was acute cholecystitis (58.1%). Other conditions included cholangitis, empyema, and hydrops. Mortality was not linked to catheter diameter or hospital stay duration. These findings suggest ICU status is a key factor in procedural outcomes.

The study found that CT-guided percutaneous cholecystostomy is a viable option for high-risk patients. Mortality rates were acceptable compared to surgical alternatives. ICU admission was a significant predictor of mortality. Other clinical variables did not impact outcomes significantly. The procedure provides a safe alternative when surgery is contraindicated. The results support the use of imaging-guided interventions in this population. The findings align with prior research on non-surgical treatments. These conclusions suggest a role for CT-guided PC in emergency care.