title: Can percutaneous cholecystostomy be a definitive management for acute acalculous cholecystitis?
abstract: OBJECTIVE
  To evaluate the safety, efficacy, and long-term outcome of percutaneous cholecystostomy without additional cholecystectomy as a definitive treatment for acute acalculous cholecystitis (AAC).
  
  
  BACKGROUND
  AAC mainly occurs in seriously ill patients, and for those considered to be at high-risk for cholecystectomy, immediate percutaneous cholecystostomy can be a simple alternative interim treatment. However, no consensus has been reached on the issue of additional cholecystectomy.
  
  
  METHODS
  The medical records of 57 patients that underwent percutaneous cholecystostomy for AAC at a single institution between 1995 and 2010 were retrospectively analyzed.
  
  
  RESULTS
  Percutaneous cholecystostomy was technically successful in all patients, and no major complications relating to the procedure were encountered. Symptoms resolved within 4 days in 53 of the 57 (93%) patients. The in-hospital mortality rate was 21% (11/57) and elective cholecystectomy was performed in 18/57 (31%). Twenty-eight patients were managed non-operatively and cholecystostomy tubes were subsequently removed. These 28 patients were follow-up over a median 32 months and recurrent cholecystitis occurred in 2 (7%).
  
  
  CONCLUSIONS
  Percutaneous cholecystostomy is an effective procedure and a good alternative for patients unfit to undergo immediate surgery because of severe sepsis or an underlying comorbidity. After patients with AAC have recovered from percutaneous cholecystostomy, further treatment such as cholecystectomy might not be needed.
authors.affiliation: Department of Medicine, Sungkyunkwan University School of Medicine, Irwon-dong, Gangnam-gu, Republic of Korea.
authors.forename: Yun Hee
authors.initials: YH
authors.lastname: Chung
authors.forename: E Ryoung
authors.initials: ER
authors.lastname: Choi
authors.forename: Kwang Min
authors.initials: KM
authors.lastname: Kim
authors.forename: Mi Jin
authors.initials: MJ
authors.lastname: Kim
authors.forename: Jong Kyun
authors.initials: JK
authors.lastname: Lee
authors.forename: Kyu Taek
authors.initials: KT
authors.lastname: Lee
authors.forename: Kwang Hyuck
authors.initials: KH
authors.lastname: Lee
authors.forename: Sung Wook
authors.initials: SW
authors.lastname: Choo
authors.forename: Young Soo
authors.initials: YS
authors.lastname: Do
authors.forename: In-Wook
authors.initials: IW
authors.lastname: Choo
mesh_terms: D042101:Acalculous Cholecystitis / Q000000981:diagnostic imaging / Q000601:surgery*; D000368:Aged; D041881:Cholecystitis, Acute / Q000000981:diagnostic imaging / Q000601:surgery*; D002767:Cholecystostomy / Q000009:adverse effects* / Q000379:methods*; D005260:Female; D006785:Hospitals, University; D006801:Humans; D008297:Male; D008875:Middle Aged; D056910:Republic of Korea; D012189:Retrospective Studies; D013997:Time Factors; D016896:Treatment Outcome; D014463:Ultrasonography