Cholecystectomy After Percutaneous Cholecystostomy for Acute Cholecystitis: Experience and Outcomes in an Academic...

Area of Science:

• Gastroenterology
• Surgical Innovation
• Clinical Outcomes Research

Background:

• Percutaneous cholecystostomy (PC) is an effective temporary treatment for acute cholecystitis (AC).
• The optimal timing for subsequent laparoscopic cholecystectomy (LC) after PC placement remains undefined.
• This gap in knowledge impacts clinical decision-making for AC management.

Purpose of the Study:

• To investigate the association between the time interval from PC to LC and patient outcomes in AC treatment.
• To identify if an optimal time gap exists to maximize benefits and minimize complications.
• To provide evidence-based recommendations for the timing of LC post-PC.

Main Methods:

• Retrospective analysis of adult patients treated for AC with PC followed by LC between 2016 and 2020.
• Inclusion of 112 patients, with data collected on demographics, PC-LC interval, and perioperative outcomes.
• Statistical review to assess the impact of the time interval on readmissions, reinterventions, and ICU stay.

Main Results:

• A median interval of 65 days between PC and LC was observed in the 112 included patients.
• No deaths or 30-day reoperations occurred; however, 14.3% were readmitted and 14.3% required reintervention.
• Longer intervals between PC and LC did not affect perioperative outcomes but were associated with significantly longer ICU stays.

Conclusions:

• Early LC following PC for AC may offer patient benefits.
• The findings suggest that delaying LC beyond a certain point does not improve outcomes and may increase ICU utilization.
• Clinical practice guidelines may need revision regarding the optimal timing of LC after PC placement for AC.