Elsevier

HPB

Volume 15, Issue 7, July 2013, Pages 511-516
HPB

Original Articles
Clinical outcomes of a percutaneous cholecystostomy for acute cholecystitis: a multicentre analysis

https://doi.org/10.1111/j.1477-2574.2012.00610.xGet rights and content
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Abstract

Background

The aim of this study was to review a series of consecutive percutaneous cholecystostomies (PC) to analyse the clinical outcomes.

Methods

All patients who underwent a PC between 2000 and 2010 were reviewed retrospectively for indications, complications, and short‐ and long‐term outcomes.

Results

Fifty‐three patients underwent a PC with a median age was 74 years (range 14–93). 92.4% (n = 49) of patients were American Society of Anesthesiologists (ASA) III and IV. 82% (43/53) had ultrasound‐guided drainage whereas 18% (10/53) had computed tomography (CT)‐guided drainage. 71.6% (n = 38) of PC's employed a transhepatic route and 28.4% (n = 15) transabdominal route. 13% (7/53) of patients developed complications including bile leaks (n = 5), haemorrhage (n = 1) and a duodenal fistula (n = 1). All bile leaks were noted with transabdominal access (5 versus 0, P = 0.001). 18/53 of patients underwent a cholecystectomy of 4/18 was done on the index admission. 6/18 cholecystectomies (33%) underwent a laparoscopic cholecystectomy and the remaining required conversion to an open cholecystectomy (67%). 13/53 (22%) patients were readmitted with recurrent cholecystitis during follow‐up of which 7 (54%) had a repeated PC. 12/53 patients died on the index admission. The overall 1‐year mortality was 37.7% (20/53).

Conclusions

Only a small fraction of patients undergoing a PC proceed to a cholecystectomy with a high risk of conversion to an open procedure. A quarter of patients presented with recurrent cholecystitis during follow‐up. The mortality rate is high during the index admission from sepsis and within the 1 year of follow‐up from other causes.

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