title: What is the fate of the cholecystostomy tube following percutaneous cholecystostomy?
abstract: Cholecystectomy is the preferred treatment for acute cholecystitis with percutaneous cholecystostomy (PC) considered an alternative therapy in severely debilitated patients. The aim of this study was to evaluate the efficacy and outcomes of PC at a tertiary referral center.
  
  
  
  We retrospectively reviewed all patients that had undergone PC from 2000 to 2014. Data collected included baseline demographics, comorbidities, details of PC placement and management, and post-procedure outcomes. The Charlson comorbidity index (CCI) was calculated for all patients at the time of PC.
  
  
  
  Four hundred and twenty-four patients underwent PC placement from 2000 to 2014, and a total of 380 patients had long-term data available for review. Within this cohort, 223 (58.7 %) of the patients were male. The mean age at the time of PC placement was 65.3 ± 14.2 years of age, and the mean CCI was 3.2 ± 2.1 for all patients. One hundred and twenty-five (32.9 %) patients went on to have a cholecystectomy following PC placement. Comparison of patients who underwent PC followed by surgical intervention revealed that they were significantly younger (p = 0.0054) and had a lower CCI (p < 0.0001) compared to those who underwent PC alone.
  
  
  
  PC placement appears to be a viable, long-term alternative to cholecystectomy for the management of biliary disease in high-risk patients. Old and frail patients benefit the most, and in this cohort PC may be the definitive treatment.
authors: Department of Hepato-Pancreato-Biliary Surgery, Digestive Disease and Surgery Institute, Cleveland Clinic, 9500 Euclid Avenue, A100 Cleveland, OH, 44195, USA. boulesm@ccf.org.
authors: M
authors: M
authors: Boules
authors: Department of Hepato-Pancreato-Biliary Surgery, Digestive Disease and Surgery Institute, Cleveland Clinic, 9500 Euclid Avenue, A100 Cleveland, OH, 44195, USA.
authors: I N
authors: IN
authors: Haskins
authors: Department of Hepato-Pancreato-Biliary Surgery, Digestive Disease and Surgery Institute, Cleveland Clinic, 9500 Euclid Avenue, A100 Cleveland, OH, 44195, USA.
authors: M
authors: M
authors: Farias-Kovac
authors: Department of Hepato-Pancreato-Biliary Surgery, Digestive Disease and Surgery Institute, Cleveland Clinic, 9500 Euclid Avenue, A100 Cleveland, OH, 44195, USA.
authors: A D
authors: AD
authors: Guerron
authors: Department of Hepato-Pancreato-Biliary Surgery, Digestive Disease and Surgery Institute, Cleveland Clinic, 9500 Euclid Avenue, A100 Cleveland, OH, 44195, USA.
authors: D
authors: D
authors: Schechtman
authors: Department of Hepato-Pancreato-Biliary Surgery, Digestive Disease and Surgery Institute, Cleveland Clinic, 9500 Euclid Avenue, A100 Cleveland, OH, 44195, USA.
authors: M
authors: M
authors: Samotowka
authors: Department of Quantitative Health Sciences, Cleveland Clinic, Cleveland, OH, USA.
authors: C P
authors: CP
authors: O'Rourke
authors: Department of Interventional Radiology, Imaging Institute, Cleveland Clinic, Cleveland, OH, USA.
authors: G
authors: G
authors: McLennan
authors: Department of Hepato-Pancreato-Biliary Surgery, Digestive Disease and Surgery Institute, Cleveland Clinic, 9500 Euclid Avenue, A100 Cleveland, OH, 44195, USA.
authors: R M
authors: RM
authors: Walsh
authors: Department of Hepato-Pancreato-Biliary Surgery, Digestive Disease and Surgery Institute, Cleveland Clinic, 9500 Euclid Avenue, A100 Cleveland, OH, 44195, USA.
authors: G
authors: G
authors: Morris-Stiff
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002763:Cholecystectomy; D041881:Cholecystitis, Acute / Q000601:surgery*; D002767:Cholecystostomy / Q000295:instrumentation* / Q000379:methods; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D062606:Tertiary Care Centers; D016896:Treatment Outcome
keywords: Acute cholecystitis; Cholecystostomy tube; Percutaneous cholecystostomy