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Long-Term Outcomes Following Percutaneous Cholecystostomy Tube Placement for Treatment of Acute Calculous Cholecystitis

  • 2016 SSAT Plenary Presentation
  • Published:
Journal of Gastrointestinal Surgery Aims and scope

Abstract

Introduction

Percutaneous cholecystostomy tube (PCT) placement is considered a safe alternative to cholecystectomy for the treatment of acute calculous cholecystitis (ACC), but data regarding long-term outcomes following PCT are limited.

Methods

We retrospectively reviewed our institutional experience of patients undergoing PCT for ACC between 1997 and 2015. Recurrent biliary events were defined as cholecystitis, cholangitis, or gallstone pancreatitis.

Results

PCT was placed for 288 patients with ACC. Mean age and age-adjusted Charlson comorbidity index were 72 ± 15 years and 5.3 ± 2.4, respectively. Following PCT placement, 91% of patients successfully resolved their episode of ACC. PCT dysfunction occurred in 132 patients (46%), with 80 patients (28%) requiring re-intervention, while 7% developed procedure-related complications. Interval cholecystectomy reduced the risk of recurrent biliary events to 7% from 21% (p = 0.002). Cholecystectomy was completed laparoscopically in 45% of patients receiving an interval operation vs. 22% of those undergoing urgent surgery for PCT failure or recurrent biliary event (p = 0.03).

Conclusions

PCT placement is a highly successful treatment for acute calculous cholecystitis and is associated with low complication rate, but high rate of tube dysfunction requiring frequent re-intervention. Interval cholecystectomy is associated with a decreased likelihood of recurrent biliary events and increased likelihood of successful laparoscopic completion.

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Author Contribution

We hereby certify that all listed co-authors were integrally involved in the formation of this manuscript via study conception/design and/or data acquisition and analysis/interpretation. Furthermore, all authors made significant contributions to the drafting or critical revisions of the manuscript, and all authors gave final approval prior to submission for publication.

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Authors and Affiliations

  1. Department of Surgery, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA

    Donna Marie L. Alvino, Zhi Ven Fong, George Velmahos, Keith D. Lillemoe & Peter J. Fagenholz

  2. Department of Interventional Radiology, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA

    Colin J. McCarthy & Peter R. Mueller

Authors
  1. Donna Marie L. Alvino
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  2. Zhi Ven Fong
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  3. Colin J. McCarthy
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  5. Keith D. Lillemoe
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  7. Peter J. Fagenholz
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Correspondence to Peter J. Fagenholz.

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Alvino, D.M.L., Fong, Z.V., McCarthy, C.J. et al. Long-Term Outcomes Following Percutaneous Cholecystostomy Tube Placement for Treatment of Acute Calculous Cholecystitis. J Gastrointest Surg 21, 761–769 (2017). https://doi.org/10.1007/s11605-017-3375-4

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  • DOI: https://doi.org/10.1007/s11605-017-3375-4

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