Percutaneous Cholecystostomy is a Feasible and Safe Option for High-Risk Acute Cholecystitis Patients

Abstract

Objective: The best option for treating high-risk patients with acute cholecystitis is still being determined. We evaluated our high-risk acute cholecystitis patients in whom we preferred percutaneous cholecystostomy and aimed to determine whether this approach was safe and feasible. 
 Methods: We retrospectively reviewed our 71 patients in whom we performed percutaneous cholecystostomy between May 2019 and July 2023. All procedures were performed with local anaesthesia under ultrasonographic guidance via the transhepatic route. The catheters were removed when the signs of acute cholecystitis were significantly regressed or when the catheters were found to be ineffective. The catheters of those eligible for surgery were removed during the operations. 
 Results: All procedures were successful without failure, and no significant complications developed in the post-intervention period. Pain at the catheter insertion site (20 patients) was the leading minor complication, and in one patient, bilioma was detected and percutaneously drained. The procedure was ineffective in 7 patients (9.85%), and the catheters were removed. In 22 patients (31%), interval cholecystectomy surgery was performed. In the subgroup of patients whose catheters were adequate and were not operated (5 patients), the catheters were removed after an average of 27.2 days. The mean length of stay was 9.6 days, and four patients died (5.6%) during the index hospitalization. 
 Conclusion: Our findings suggest that percutaneous cholecystostomy is a feasible, safe and highly effective treatment option for acute cholecystitis in high-risk patients.