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What is the fate of the cholecystostomy tube following percutaneous cholecystostomy?

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Abstract

Introduction

Cholecystectomy is the preferred treatment for acute cholecystitis with percutaneous cholecystostomy (PC) considered an alternative therapy in severely debilitated patients. The aim of this study was to evaluate the efficacy and outcomes of PC at a tertiary referral center.

Methods

We retrospectively reviewed all patients that had undergone PC from 2000 to 2014. Data collected included baseline demographics, comorbidities, details of PC placement and management, and post-procedure outcomes. The Charlson comorbidity index (CCI) was calculated for all patients at the time of PC.

Results

Four hundred and twenty-four patients underwent PC placement from 2000 to 2014, and a total of 380 patients had long-term data available for review. Within this cohort, 223 (58.7 %) of the patients were male. The mean age at the time of PC placement was 65.3 ± 14.2 years of age, and the mean CCI was 3.2 ± 2.1 for all patients. One hundred and twenty-five (32.9 %) patients went on to have a cholecystectomy following PC placement. Comparison of patients who underwent PC followed by surgical intervention revealed that they were significantly younger (p = 0.0054) and had a lower CCI (p < 0.0001) compared to those who underwent PC alone.

Conclusions

PC placement appears to be a viable, long-term alternative to cholecystectomy for the management of biliary disease in high-risk patients. Old and frail patients benefit the most, and in this cohort PC may be the definitive treatment.

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Author's contribution

Mena Boules and Ivy N. Haskins were involved in writing of manuscript and data entry; Mario Farias-Kovac and David Schechtman were involved in data entry; Alfredo Daniel Guerron was involved in data entry/study concept: Gordon McLennan and Michael Samotowka were involved in study concept; Colin P. O’Rourke was involved in statistical support; R. Matthew Walsh was involved in final review/study concept; and Gareth Morris-Stiff was involved in final writing of manuscript/final review/study concept.

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Authors and Affiliations

  1. Department of Hepato-Pancreato-Biliary Surgery, Digestive Disease and Surgery Institute, Cleveland Clinic, 9500 Euclid Avenue, A100 Cleveland, OH, 44195, USA

    M. Boules, I. N. Haskins, M. Farias-Kovac, A. D. Guerron, D. Schechtman, M. Samotowka, R. M. Walsh & G. Morris-Stiff

  2. Department of Quantitative Health Sciences, Cleveland Clinic, Cleveland, OH, USA

    C. P. O’Rourke

  3. Department of Interventional Radiology, Imaging Institute, Cleveland Clinic, Cleveland, OH, USA

    G. McLennan

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  1. M. Boules
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  2. I. N. Haskins
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  3. M. Farias-Kovac
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  4. A. D. Guerron
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  6. M. Samotowka
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  7. C. P. O’Rourke
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  8. G. McLennan
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  9. R. M. Walsh
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  10. G. Morris-Stiff
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Corresponding author

Correspondence to M. Boules.

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Disclosures

Dr. Mena Boules, Dr. Ivy Haskins, Dr. Mario Farias-Kovac, Dr. Alfredo Daniel Guerron, David Schechtman, Dr. Gordon McLennan, Dr. Michael Samotowka, Colin P. O’Rourke, Dr. R. Matthew Walsh and Dr. Gareth Morris-Stiff have no conflicts of interest or financial ties to disclose.

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Boules, M., Haskins, I.N., Farias-Kovac, M. et al. What is the fate of the cholecystostomy tube following percutaneous cholecystostomy?. Surg Endosc 31, 1707–1712 (2017). https://doi.org/10.1007/s00464-016-5161-x

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  • DOI: https://doi.org/10.1007/s00464-016-5161-x

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