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[Percutaneous cholecystostomy in multi-field hospital]
D V Mizgirev1,2, D I Barinova1, A Yu Teterin2
1Northern State Medical University, Arkhangelsk, Russia.
Khirurgiia
|December 30, 2022
Summary
Percutaneous cholecystostomy is a rare intervention for acute cholecystitis and obstructive jaundice. Using a locking thread significantly reduces catheter migration, improving outcomes for this gallbladder drainage procedure.
Area of Science:
- Minimally Invasive Surgery
- Interventional Radiology
- Gastroenterology
Context:
- Percutaneous cholecystostomy is a reserved procedure for patients with acute cholecystitis or obstructive jaundice who are poor surgical candidates.
- This study analyzes a 13-year experience with percutaneous cholecystostomy at a single center.
Purpose:
- To evaluate the indications, technical aspects, and clinical outcomes of percutaneous cholecystostomy.
- To assess the efficacy of locking threads in preventing catheter migration.
- To analyze mortality rates in relation to patient conditions and procedure outcomes.
Summary:
- Indications included acute cholecystitis (63.5%) and obstructive jaundice (36.5%). Locking threads reduced catheter migration from 41.2% to 13.6% (p=0.033).
- Subsequent cholecystectomy was needed in 15.9% of cases. Mortality was 36.5% overall, higher in Grade III acute cholecystitis (75.0%) versus Grade II (21.9%; p=0.008).
Impact:
- Locking threads are crucial for stabilizing cholecystostomy catheters, minimizing complications like migration.
- Patient selection and management of comorbidities are critical for optimizing outcomes in acute cholecystitis treated with cholecystostomy.
- Percutaneous cholecystostomy remains a valuable, albeit rare, intervention for specific patient groups requiring gallbladder drainage.
