TU8.2 Percutaneous cholecystostomy for acute calculous cholecystitis an observational study from a single institute

Abstract

Abstract Introduction Although percutaneous cholecystostomy (PC) is generally accepted as a bridge to definitive therapy for acute cholecystitis (AC), which remains cholecystectomy, some patients did not undergo cholecystectomy mostly due to contraindications to surgery. Here, we aimed to audit our clinical practice from a single institute. Methods 153 patients presented with AC and initially managed with PC were included. The proportion of patients who did not undergo subsequent LC and their characteristics were analysed. Results 27% (41/153) of the study cohort underwent LC while the remaining patients (n=112) did not receive any surgical intervention.22/122(20%) were presented with AC and coexisting hepatobiliary malignancy. The mean age of the remaining patients (n=90) was 75±13 years and the median length of drain insertion of those patients 40 days. The majority (57%) was presented with sever AC while 8% had AC with adjacent liver abscess. 55% of those patients did not develop any further attacks of AC after PC removal while 25% deemed unfit for surgery. The rest of the patients (20%) either refused the operation or died before LC. The American Society of Anaesthesiologists (ASA) score was 3 IV in 9% of patients (8/90). 15% (13/90) experienced post PC complications including either blocked stent, pain and cellulitis around tube. The 60-day mortality rate of patients who did not underwent LC was 11% (10/90). Conclusion The majority of AC patients treated initially with PC did not undergo subsequent LC. PC in high surgical risk patients with AC could be consider as definitive treatment.