Sa1323 LONG-TERM OUTCOMES OF PATIENTS WITH ACUTE ACLCULOUS CHOLECYSTITIS AFTER SUCCESSFUL REMOVAL OF GALLSTONES WITH PERCUTANEOUS TANSHEPATIC CHOLANGIOSCOPY: A DECADE EXPERIENCE AT A SINGLE TERTIARY CENTER

Abstract

Percutaneous cholecystostomy (PCT) has been an alternative treatment of acute calculous cholecystitis (ACC) for the patients unsuitable for early cholecystectomy. Lithotomy with percutaneous transhepatic cholangioscopy (PTCS) after PCT track maturation is particularly considered for those patients with gallbladder (GB) stones who are poor surgical candidate. We examined the long-term outcomes of 171 patients with ACC treated by PTCS. This study was a retrospective observational study of 171 consecutive patients who treated with PTCS for ACC in the period from 1 Jan 2005 to 31 Dec 2015. Outcome measures included the success rates, adverse events, recurrence rate and mortality. The patient All data were collected from patients' medical records. PTCS achieved complete clearance of GB stones in 157 patients (91.8 %). The complication rate of of PTCS was 3.5 % (6/171). The adverse events included GB perforation (n = 3, 1.8 %), hemorrhage (n = 2, 1.2 %), disruption of the percutaneous trans-hepatic biliary drainage fistula (n = 1, 0.6 %), and all of which resolved with conservative treatment. The overall recurrence rate of gallstone diseases was 11.5% during the follow up period. The incidence of recurrent gallstone diseases was significantly higher in those with completely removed GB stones than in those without complete clearance (10.2 %, 16/157 vs 21.4 %, 3/14; p < 0.05). The frequency of recurrence of gallstone disease in patients with contrast passage to the duodenum on cholangiography after PTCS was lower than that in patients without contrast passage. Gallbladder stone removal with PTCS would be recommended as an effective and safe treatment modality for the patients with acute cholecystitis who are unsuitable for surgery.