Percutaneous cholecystostomy for acute cholecystitis in elderly patients with comorbidities: Long-term outcomes after successful treatment and the risk factors for recurrence

Abstract

Background/AimPercutaneous cholecystostomy (PC) has been effectively used for the treatment of acute cholecystitis (AC) for patients unfit for early cholecystectomy. This study investigates the recurrence rate after successful PC and factors associated with recurrence. Patients and methodsThis was a retrospective descriptive review of the medical records of 71 patients that underwent PC for AC at a single institution between 2000 and 2016. Primary outcome was relief of cholecystitis and need for later cholecystectomy after successful PC. Secondary outcomes were hospital stay, catheter dwell-time, catheter problems and complications following the procedure. We used multivariable logistic regression analysis sequentially to identify factors associated with each outcome. ResultsPC was initially successful and symptoms disappeared within 96hours in all patients. In total, 67 of 71 (94.4%) patients had recovered by PC only and were discharged. During follow-ups, 7 patients succumbed to their underlying diseases (unrelated to AC) and they were not included into analyses since they did not survive one year after successful intervention. The one-year recurrence rate was 23.3% (14/60). Perforation of the gallbladder, presence of bile duct stones, C-reactive protein, hospital stay and catheter dwell-time positively correlated (P<0.05) with one-year recurrence. Hospital stay and catheter dwell-time were 16.8±6.3 and 19.1±9.8 days, respectively. ConclusionPatients with AC were promptly relieved from their symptoms following PC. The one-year recurrence rate was relatively low after successful PC. Predictors for recurrence included the severity of initial AC and subsequently provided treatments.