Outcomes of Percutaneous Cystic Duct Stent Placement for Acute Cholecystitis

To evaluate whether PCDS placement is safe and effective for nonsurgical patients with acute cholecystitis and cystic duct (CD) anatomy predicts technical success.

Retrospective analysis of 118 consecutive patients who underwent PCDS (double pigtail plastic stent) attempts after percutaneous cholecystostomy tube (PCT) placement between September 2018 and September 2024 was performed. The primary endpoint was technical success, defined as successful deployment of a CD stent. Secondary endpoints included clinical success (symptom resolution without recurrence), adverse events, and successful removal of the safety drain.

A total of 134 PCDS attempts were performed. Eighty-six patients (73%) had a patent CD and normal CD anatomy, and technical success rate was 95.3%. In 17 patients (17/118, 14.4%), the CD was not visualized, and the primary and secondary technical success rates were lower at 5.9% and 28.5%, respectively. In patients with aberrant or complex CD anatomy, the technical success rate was 34.4%. Overall, PCDS placement was successful in a total of 94 (79.7%) of 118 final patients. Adverse events occurred in 7.4% of successful cases, including 6 episodes of acute chemical pancreatitis managed conservatively. PCT removal after clamp trial was achieved in 91.5% of patients.

PCDS placement is a feasible, safe, and effective treatment in nonsurgical patients. Technical success is impacted by CD patency and anatomy. Overall, PCDS placement is a viable option to avoid the long-term presence of a PCT, thereby improving patient's quality of life.