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Comparing outcomes of percutaneous cholecystostomy drain placement between patients within and outside of Tokyo guidelines diagnostic criteria for acute cholecystitis

  • Interventional Radiology
  • Published:
Abdominal Radiology Aims and scope Submit manuscript

Abstract

Objective

To compare outcomes following percutaneous cholecystostomy drain placement based on presence or absence of Tokyo Guidelines diagnostic criteria for acute cholecystitis.

Methods

Chart review was performed to identify the presence or absence of Tokyo Guidelines diagnostic criteria for acute cholecystitis in 146 patients who underwent percutaneous cholecystostomy between 2012 and 2015. Those who met criteria were compared to those who did not in terms of demographics, laboratory values, drain indwelling time, treatment response, eventual surgical management, and 30-day mortality.

Results

94 patients (64%) met Tokyo Guidelines diagnostic criteria, while 52 did not (36%). Patients within criteria had a shorter mean length of stay (13.5 days vs 18.9 days), were more likely to have a positive gallbladder fluid culture (64.5% vs 28.6%), demonstrated greater response to treatment (87.2% vs 32.7%), and had lower 30-day mortality (6.4% vs 37.8%). There was no significant difference in terms of ICU requirement (38.3% vs 38.9%), mean drain indwelling time (58.8 days vs 65.3 days), eventual laparoscopic cholecystectomy (40.4% vs 25.0%), or open cholecystectomy performed (9.5% vs 9.6%).

Conclusion

Patients outside of Tokyo Guidelines diagnostic criteria for acute cholecystitis were less likely to respond to treatment with percutaneous cholecystostomy and had worse outcomes. Further research may be indicated to better define the indications for percutaneous cholecystostomy placement in this group.

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Funding

No funding was used for this research.

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Authors and Affiliations

  1. Section of Vascular and Interventional Radiology, Department of Radiology, University of Chicago Medicine, 5841 S Maryland Ave, MC2026, Chicago, IL, 60367, USA

    Alex Lionberg, Thomas Tullius & Thuong Van Ha

  2. Pritzker School of Medicine, University of Chicago, Chicago, IL, USA

    Teresa Jiang, Chukwuemeka Okafor & Travis Wassermann

Authors
  1. Alex Lionberg
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  2. Thomas Tullius
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  3. Teresa Jiang
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  4. Chukwuemeka Okafor
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  5. Travis Wassermann
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  6. Thuong Van Ha
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Contributions

Conception and design: AL, TT, TVH. Administrative support: TVH. Provision of study materials or patients: AL, TT, TVH. Collection and assembly of data: AL, TT, TJ, CO, TW. Data analysis and interpretation: AL, TT, TVH. Manuscript writing: all authors. Final approval of manuscript: all authors.

Corresponding author

Correspondence to Alex Lionberg.

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Conflict of interest

The authors declare that they have no conflict of interest.

Ethics approval

The authors are accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved. Institutional review board approval was obtained for this study (IRB16-1127). Although informed consent is not required for this type of study, patient’s personal data were kept secured throughout the duration of the study. The study outcomes have not affected the future management of the patients. Ethical approval was waived by the local Ethics Committee of University of Chicago Medicine in view of the retrospective nature of the study and all the procedures being performed were part of the routine care.

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Lionberg, A., Tullius, T., Jiang, T. et al. Comparing outcomes of percutaneous cholecystostomy drain placement between patients within and outside of Tokyo guidelines diagnostic criteria for acute cholecystitis. Abdom Radiol 46, 1188–1193 (2021). https://doi.org/10.1007/s00261-020-02767-1

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  • DOI: https://doi.org/10.1007/s00261-020-02767-1

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