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European Radiology

, Volume 28, Issue 4, pp 1449–1455 | Cite as

Role of percutaneous cholecystostomy for acute acalculous cholecystitis: clinical outcomes of 271 patients

  • Seung Yeon Noh
  • Dong Il Gwon
  • Gi-Young Ko
  • Hyun-Ki Yoon
  • Kyu-Bo Sung
Interventional
  • 266 Downloads

Abstract

Objectives

To examine the outcomes of percutaneous cholecystostomy (PC) in patients with acute acalculous cholecystitis (AAC).

Methods

The study population comprised 271 patients (mean age, 72 years; range, 22–97 years, male, n=169) with AAC treated with PC with or without subsequent cholecystectomy. Clinical data from total 271 patients were analysed, and outcomes were assessed according to whether the catheter was removed or remained indwelling. Patient survival and recurrence rates were calculated.

Results

Symptom resolution and significant improvement of laboratory test values were achieved in 235 patients (86.7%) within 4 days after PC. Complications occurred in six patients (2.2%). Interval elective cholecystectomy was performed in 127 (46.8%) patients. Among the remaining 121 patients, successful removal of the PC catheter was achieved in 88 patients (72.7%) at a mean of 30 days (range, 4–365 days). Of the catheter removal group, 86/88 (97.7%) were successfully treated with the initial PC, whereas two (2.3%) experienced recurrence of cholecystitis. Cumulative recurrence rates were 1.1%, 2.7%, and 2.7% at 1, 2, and 8 years, respectively.

Conclusions

The good therapeutic outcomes of PC and low recurrence rate suggest that PC can be a definitive treatment option in the majority of AAC patients.

Key Points

Many patients with AAC are too ill to undergo cholecystectomy.

PC in AAC patients shows low complication and recurrence rate.

PC solely can be a definitive treatment option in the majority of AAC patients

Keywords

Acalculous cholecystitis Cholecystitis, Acute Cholecystostomy Gallbladder Radiology, Interventional 

Abbreviations

AAC

Acute acalculous cholecystitis

ALT

Alanine aminotransferase

ASA

American Society of Anaesthesiologists

AST

Aspartate aminotransferase

CRP

C-reactive protein

GB

Gallbladder

INR

International normalisation ratio

MRCP

Magnetic resonance cholangiopancreatography

PC

Percutaneous cholecystostomy

WBC

White blood cell

Notes

Funding

The authors state that this work has not received any funding.

Compliance with ethical standards

Guarantor

The scientific guarantor of this publication is Ji Hoon Shin.

Conflict of interest

The authors of this manuscript declare no relationships with any companies, whose products or services may be related to the subject matter of the article.

Statistics and biometry

No complex statistical methods were necessary for this paper.

Informed consent

Written informed consent was waived by the Institutional Review Board.

Ethical approval

Institutional Review Board approval was obtained.

Methodology

• retrospective

• observational

• performed at one institution

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Copyright information

© European Society of Radiology 2017

Authors and Affiliations

  • Seung Yeon Noh
    • 1
  • Dong Il Gwon
    • 1
  • Gi-Young Ko
    • 1
  • Hyun-Ki Yoon
    • 1
  • Kyu-Bo Sung
    • 1
  1. 1.Department of Radiology and Research Institute of Radiology, Asan Medical CenterUniversity of Ulsan College of MedicineSongpa-guKorea

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