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

  • Interventional
  • Published:
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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

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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

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Authors and Affiliations

  1. Department of Radiology and Research Institute of Radiology, Asan Medical Center, University of Ulsan College of Medicine, 88 Olympic Ro, 43-Gil, Songpa-gu, Seoul, 05505, Korea

    Seung Yeon Noh, Dong Il Gwon, Gi-Young Ko, Hyun-Ki Yoon & Kyu-Bo Sung

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  1. Seung Yeon Noh
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  2. Dong Il Gwon
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  3. Gi-Young Ko
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  4. Hyun-Ki Yoon
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Correspondence to Dong Il Gwon.

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The scientific guarantor of this publication is Ji Hoon Shin.

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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.

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Written informed consent was waived by the Institutional Review Board.

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Methodology

• retrospective

• observational

• performed at one institution

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Noh, S.Y., Gwon, D.I., Ko, GY. et al. Role of percutaneous cholecystostomy for acute acalculous cholecystitis: clinical outcomes of 271 patients. Eur Radiol 28, 1449–1455 (2018). https://doi.org/10.1007/s00330-017-5112-5

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  • DOI: https://doi.org/10.1007/s00330-017-5112-5

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