title: Percutaneous cholecystolithotomy: risks, benefits, and long-term outcome.
abstract: BACKGROUND
  For symptomatic patients with gallbladder stones and a patent cystic duct who wish to retain their 'functioning' gallbladders, percutaneous cholecystolithotomy (PCCL) offers an alternative to open or laparoscopic cholecystectomy. However, there are few data on the risks and benefits of this approach or on the long-term outcome.
  
  
  RESULTS
  In 21 patients with symptomatic calcified gallstones, PCCL was successful (gallstone clearance) in 17 (81%). Four to 62 (median, 35) months after clearance 9 of the 17 remained symptom-free and stone-free, whereas 4 developed biliary sludge at 7, 30, 32, and 35 months, 2 of whom subsequently developed gallstones. In four other patients gallstones recurred without evidence of preceding biliary sludge at 9, 16, 19, and 27 months, corresponding to an actuarial gallstone recurrence rate at 36 months of 53.4 +/- SEM 15.1%, and a combined stone/sludge recurrence rate of 63.4 +/- 13.5%.
  
  
  CONCLUSIONS
  PCCL is moderately effective but, because of the frequency of complications and sludge/stone recurrence, is likely to have only a limited residual role in the era of laparoscopic cholecystectomy.
authors.affiliation: Gastroenterology Unit, Guy's Hospital Campus, UMDS, London, England.
authors.forename: S P
authors.initials: SP
authors.lastname: Pereira
authors.forename: J P
authors.initials: JP
authors.lastname: Ellul
authors.forename: A
authors.initials: A
authors.lastname: Keightley
authors.forename: C
authors.initials: C
authors.lastname: Kennedy
authors.forename: J
authors.initials: J
authors.lastname: Dick
authors.forename: R H
authors.initials: RH
authors.lastname: Dowling
mesh_terms: D002767:Cholecystostomy / Q000379:methods; D002769:Cholelithiasis / Q000453:epidemiology / Q000601:surgery*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000453:epidemiology; D011677:Punctures / Q000379:methods; D012008:Recurrence; D013997:Time Factors; D016896:Treatment Outcome