Can Percutaneous Cholecystostomy Be a Definitive Treatment in High Risk Acute Cholecystitis Patient? A Retrospective 10 Years Outcome
Pongsatorn Tangtawee MD*, Songkiat Yookhong MD*, Somkit Mingphruedhi MD*
Affiliation : * Division of Hepato-Pancreato-Biliary Surgery, Department of Surgery, Faculty of Medicine Ramathibodi Hospital, Mahidol University, Bangkok, Thailand
Background : Although, cholecystectomy is a definitive treatment in acute cholecystitis patient but is high risk for surgery
patient. Therefore, percutaneous cholecystostomy (PC) was the alternative treatment. However, after the treatment, most
patients still are unfit for interval cholecystectomy. The outcomes of these patients after PC with gallbladder in situ are unclear.
Objective : The aim of the present study is to assess the efficacy and clinical outcome on AC patients that underwent PC
placement.
Material and Method: A retrospective study of all the patients treated with PC for acute cholecystitis in Ramathibodi Hospital,
between 2006 and 2016 was conducted. The data was collected from medical records.
Results : Sixty high-risk acute cholecystitis patients were successful treated with PC. Fifty-seven patients (95%) had their
conditions improved and could be discharged home about two weeks after PC. Three patients (5%) died in hospital. Forty-
one patients (68.3%) were definitively treated with PC (GB in situ) and six patients (14.6%) had recurrent biliary symptoms.
Median time of recurrence was 135.5 days. Twelve patients (20%) underwent cholecystectomy after PC and four patients(6.7%)
were lost to follow-up. Six (10%) patients had immediate complications after PC such as intra-abdominal collection, minimal
bile leakage, or PC displacement.
Conclusion : PC could be an alternative interim treatment as a less invasive method of treating the acute process to avoid
extra morbidity and mortality of cholecystectomy under the emergency setting in high-risk acute cholecystitis patients. After the
PC tube was removed, the gallbladder can be left in situ with a low recurrence rate of biliary event.
Keywords : Percutaneous cholecystostomy, Cholecystitis, Cholecystectomy
