title: Percutaneous cholecystostomy is an effective definitive treatment option for acute acalculous cholecystitis.
abstract: OBJECTIVE
  Acute acalculous cholecystitis can be treated with percutaneous cholecystostomy in critically ill patients unfit for surgery. However, the evidence on the outcome is sparse. We conducted a retrospective analysis of acute acalculous cholecystitis patients treated with percutaneous cholecystostomy during a 10-year study period.
  
  
  METHODS
  An observational study of 56 consecutive patients treated with percutaneous cholecystostomy for acute acalculous cholecystitis was conducted in the period from 1 June 2002 to 31 May 2012. All data were obtained by review of medical records.
  
  
  RESULTS
  A total of 56 consecutive patients were treated with percutaneous cholecystostomy for acute acalculous cholecystitis. Six patients (10.7%) died within 30 days after the procedure. Percutaneous cholecystostomy could serve as a definitive treatment option in 45 patients (80.4%), whereas 1 patient (1.8%) required cholecystectomy due to recurrence of cholecystitis. Four patients (7.1%) were treated with percutaneous cholecystostomy as a bridging procedure to subsequent elective laparoscopic cholecystectomy within a median of 8.8 months (range: 7.7-33.4 months). There was no significant difference in the risk of cholecystitis recurrence between patients with (6/37) and without (2/3) contrast passage to the duodenum on cholangiography (p = 0.096).
  
  
  CONCLUSIONS
  Percutaneous cholecystostomy is successful as a definitive treatment option in the majority of patients with acute acalculous cholecystitis. It is associated with a low rate of mortality and subsequent cholecystectomy.
authors.affiliation: Department of Surgical Gastroenterology L, Aarhus University Hospital, Aarhus C, Denmark jakob.kirkegaard@auh.rm.dk.
authors.forename: J
authors.initials: J
authors.lastname: Kirkegård
authors.affiliation: Department of Surgical Gastroenterology L, Aarhus University Hospital, Aarhus C, Denmark.
authors.forename: T
authors.initials: T
authors.lastname: Horn
authors.affiliation: Department of Surgical Gastroenterology L, Aarhus University Hospital, Aarhus C, Denmark.
authors.forename: S D
authors.initials: SD
authors.lastname: Christensen
authors.affiliation: Department of Radiology, Aarhus University Hospital, Aarhus C, Denmark.
authors.forename: L P
authors.initials: LP
authors.lastname: Larsen
authors.affiliation: Department of Surgical Gastroenterology L, Aarhus University Hospital, Aarhus C, Denmark.
authors.forename: A R
authors.initials: AR
authors.lastname: Knudsen
authors.affiliation: Department of Surgical Gastroenterology L, Aarhus University Hospital, Aarhus C, Denmark.
authors.forename: F V
authors.initials: FV
authors.lastname: Mortensen
mesh_terms: D042101:Acalculous Cholecystitis / Q000175:diagnosis / Q000401:mortality / Q000601:surgery*; D000208:Acute Disease; D000368:Aged; D000369:Aged, 80 and over; D000465:Algorithms; D002760:Cholangiopancreatography, Endoscopic Retrograde; D049448:Cholangiopancreatography, Magnetic Resonance; D002763:Cholecystectomy / Q000379:methods*; D003718:Denmark / Q000453:epidemiology; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000453:epidemiology; D012189:Retrospective Studies; D015996:Survival Rate / Q000639:trends; D013997:Time Factors; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome
keywords: Acalculous cholecystitis; cholecystitis; cholecystostomy; outcome; percutaneous cholecystostomy