Evaluating Percutaneous Gallbladder Drainage: 10-Year Outcomes From a Large District General Hospital in the UK

Background Acute cholecystitis (AC) is a common surgical emergency, and early laparoscopic cholecystectomy (LC) is considered the standard treatment. However, some patients are unsuitable for surgery due to advanced age, multiple comorbidities, or poor physiological reserve. In these cases, gallbladder drainage is required, most commonly performed using percutaneous transhepatic gallbladder drainage (PTGBD). This study evaluates the outcome of PTGBD in a large UK District General Hospital (DGH). Methods A retrospective analysis was performed of all patients undergoing PTGBD between November 2013 and December 2023 in a single UK DGH. Data collected included demographics, indications, procedural success, complications, need for reintervention, mortality, and subsequent surgical management. Results A total of 47 patients underwent PTGBD (55.3% male, n=26), 71.7% American Society of Anesthesiologists (ASA) grade 3 (n=34). The main indications were AC (78.7%, n=37) and gallbladder perforation (19.1%, n=9). Technical and clinical success rates were 97.8% (n=46) and 92.3% (n=43), respectively. Thirty-day and 90-day mortality were 2.2% (n=1) and 6.8% (n=3), respectively. Reintervention was required in 43.5% of patients (n=20), and 54% (n=25) experienced unplanned readmission, most commonly due to recurrent cholecystitis or drain-related complications. Conclusion PTGBD is an effective, early source control in high-risk patients with AC, with high success rates and acceptable mortality. However, high rates of reintervention and readmission highlight important limitations of this approach. Its use should depend on local expertise and careful outcome monitoring.