title: Percutaneous cholecystostomy: the radiologist's role in treating acute cholecystitis.
abstract: Acute cholecystitis is a common condition, with laparoscopic cholecystectomy considered the gold-standard for surgical management. However, surgical options are often unfavourable in patients who are very unwell, or have numerous medical co-morbidities, in which the mortality rates are significant. Percutaneous cholecystostomy (PC) is an image-guided intervention, used to decompress the gallbladder, reducing patient's symptoms and the systemic inflammatory response. PC has been shown to be beneficial in high-risk patient groups, predominantly as a bridging therapy; allowing safer elective cholecystectomy once the patient has recovered from the acute illness; or, in the minority, as a definitive treatment in patients deemed unfit for surgery. This review aims to develop a broader understanding of PC, discussing its specific indications, patient management, technical factors, imaging guidance, and outcomes following the procedure.
authors.affiliation: Department of Radiology, Oxford University Hospitals, John Radcliffe Hospital, Headington, Oxford, UK.
authors.forename: M W
authors.initials: MW
authors.lastname: Little
authors.forename: J H
authors.initials: JH
authors.lastname: Briggs
authors.forename: C R
authors.initials: CR
authors.lastname: Tapping
authors.forename: M J
authors.initials: MJ
authors.lastname: Bratby
authors.forename: S
authors.initials: S
authors.lastname: Anthony
authors.forename: J
authors.initials: J
authors.lastname: Phillips-Hughes
authors.forename: R
authors.initials: R
authors.lastname: Uberoi
mesh_terms: D000700:Analgesics / Q000627:therapeutic use; D002404:Catheterization / Q000379:methods; D041881:Cholecystitis, Acute / Q000601:surgery*; D002767:Cholecystostomy / Q000379:methods*; D016292:Procedural Sedation; D000075202:Contraindications; D003422:Critical Care; D019299:Decompression, Surgical / Q000379:methods*; D005260:Female; D006801:Humans; D007676:Kidney Failure, Chronic / Q000150:complications; D011182:Postoperative Care / Q000379:methods; D011247:Pregnancy; D011248:Pregnancy Complications / Q000601:surgery; D015641:Radiography, Interventional; D013048:Specimen Handling; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome; D018084:Ultrasonography, Interventional
chemical_list: D000700:Analgesics