Percutaneous cholecystostomy is an effective treatment option for acute calculous cholecystitis: a 10-year experience.
BACKGROUND
Percutaneous cholecystostomy (PC) can be used to treat patients with acute calculous cholecystitis (ACC) who are considered to be unfit for surgery. However, this procedure has been insufficiently investigated. This paper presents the results of a 10-year experience with this treatment modality.


METHODS
A retrospective observational study of all consecutive patients treated with PC for ACC in the period from 1 May 2002 to 30 April 2012 was conducted. All data were collected from patients' medical records.


RESULTS
A total of 278 patients were treated with PC for ACC. Of these, 13 (4.7%) died within 30 days, 28 (10.1%) underwent early laparoscopic cholecystectomy and three (1.1%) patients were lost from follow-up. Of the remaining 234 patients, 55 (23.5%) were readmitted for the recurrence of cholecystitis. In 128 (54.7%) patients, PC was the definitive treatment (median follow-up time: 5 years), whereas 51 (21.8%) patients were treated with elective laparoscopic cholecystectomy. The frequency of recurrence of cholecystitis in patients with contrast passage to the duodenum on cholangiography was lower than that in patients without contrast passage (21.1% versus 36.7%; P = 0.037).


CONCLUSIONS
The present study, which is the largest ever conducted in this treatment area, supports the hypothesis that PC is an effective treatment modality for critically ill patients with ACC unfit for surgery and results in a low rate of 30-day mortality.
Department of Surgical Gastroenterology L, Aarhus University Hospital, Aarhus, Denmark.
Torben
T
Horn
Sara D
SD
Christensen
Jakob
J
Kirkegård
Lars P
LP
Larsen
Anders R
AR
Knudsen
Frank V
FV
Mortensen
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D017081:Cholecystectomy, Laparoscopic; D041881:Cholecystitis, Acute / Q000175:diagnosis / Q000401:mortality / Q000601:surgery*; D002767:Cholecystostomy / Q000009:adverse effects / Q000379:methods* / Q000401:mortality; D002769:Cholelithiasis / Q000175:diagnosis / Q000401:mortality / Q000601:surgery*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010359:Patient Readmission; D018579:Patient Selection; D012008:Recurrence; D012086:Reoperation; D012189:Retrospective Studies; D012307:Risk Factors; D013997:Time Factors; D016896:Treatment Outcome; D055815:Young Adult