Radiologically guided percutaneous cholecystostomy for acute cholecystitis: long-term outcome in 50 patients

Area of Science:

• Gastroenterology
• Interventional Radiology
• Surgical Outcomes

Background:

• Acute cholecystitis is inflammation of the gallbladder.
• Percutaneous cholecystostomy is a minimally invasive drainage procedure.
• Long-term outcomes of this initial treatment are not well-established.

Purpose of the Study:

• To evaluate the long-term outcomes of patients with acute cholecystitis initially treated with percutaneous cholecystostomy.
• To compare outcomes between calculous and acalculous cholecystitis.
• To determine the efficacy of percutaneous cholecystostomy as a temporizing or definitive treatment.

Main Methods:

• Retrospective review of medical and radiology records.
• Inclusion of all patients treated with percutaneous cholecystostomy for acute cholecystitis from January 1990 to September 1993.
• Analysis of subsequent treatments, complications, and mortality.

Main Results:

• 29 patients had calculous cholecystitis; 79% eventually underwent surgery or stone removal.
• 21 patients had acalculous cholecystitis; only 24% required further surgery.
• Percutaneous cholecystostomy was curative in most acalculous cases, avoiding cholecystectomy.

Conclusions:

• Percutaneous cholecystostomy is an effective temporizing measure for acute cholecystitis, particularly calculous cases, facilitating elective surgery.
• For acalculous cholecystitis, percutaneous cholecystostomy is frequently curative, obviating the need for cholecystectomy.
• This procedure offers a valuable management option for acute cholecystitis, improving patient outcomes.