EGS P25 Patient outcomes after percutaneous cholecystostomy at Dorset County Hospital

Abstract

Abstract Background No guideline for percutaneous cholecystostomy exists at Dorset County Hospital, nor has an audit looking into patient outcomes after percutaneous cholecystostomy previously been carried out. This audit aims to identify the indications for cholecystostomy insertion, timing of insertion, complications thereafter, timing of any tubograms, and follow-up of patients after cholecystostomy. No universal management guidelines for percutaneous cholecystostomy currently exist, though studies have proposed treatment algorithms. Methods Retrospective cohort audit of all patients who underwent cholecystostomy insertion at Dorset County Hospital over 6 years from January 2017 – December 2022. Data was provided by the local radiology department of all abdominal drains inserted in this period, with further information collected from discharge summaries, clinic letters and tubogram data on local clinical systems. Data was inputted to and analysed on Microsoft excel. Results Between 2017 – 2022, 38 cholecystostomy drains were inserted. More men than women received drains, with a mean age of 71.8 at insertion. Inpatient stay varied from 2-71 days, with mean of 3 days between admission and drain insertion. 30 patients avoided cholecystectomy, whilst 34% of patients were re-admitted with drain-related or underlying pathology-associated complications. Conclusions Indications for drain insertion are in keeping with medical literature as a means of biliary sepsis control. Cholecystostomy was the definitive gallstone disease procedure for most patients. Most also had tubograms, yet tubogram timings varied significantly likely reflecting the lack of universally accepted management guidelines. This audit identified patients who have benefited from cholecystostomy insertion, allowing creation of a local management guideline for patients with biliary sepsis who undergo percutaneous cholecystostomy.