Image Guided Percutaneous Cholecystostomy–A Single Center Experience

Abstract

Purpose To assess the technical feasibility of percutaneous cholecystostomy (PCC) for acute cholecystitis and formulate an algorithm for PCC.

Materials and methods This is a retrospective study of 35 patients (28 male and 7 female; mean age 60 years) who underwent image-guided PCC from 2008 to 2018 at a tertiary care hospital in South India. Descriptive summary statistics and frequencies were used to assess the technical success and complications.

Results The patients (35/35) presented with fever, abdominal pain, and a few of them had severe sepsis. All these patients were high risk for surgery considering the comorbidities (17/35) and hemodynamic instability (18/35). PCC was performed under ultrasoundguidance, through transhepatic approach, and using single puncture and modified single puncture techniques. The procedure was technically successful in all 35 patients (100%). Two patients (2/35) did not improve clinically after PCC; hence, they were taken up for emergency cholecystectomy with high-risk consent. One patient required a repeat procedure after 3 days due to tube dislodgement. There were no major procedure-related complications.

Conclusion Image-guided PCC can be performed safely and is effective for treating high-risk patients with acute cholecystitis.

Keywords

percutaneous cholecystostomy - ultrasound guidance - single puncture technique

Publikationsverlauf

Artikel online veröffentlicht:
29. April 2020

• References

• 1 Nahrwold DL. Acute cholecystitis. In: Sabiston D. ed. Textbook of Surgery. 15th ed. Philadelphia, PA: Saunders; 1997: 1126-1131
• 2 Hsieh YC, Chen CK, Su CW. et al. Outcome after percutaneous cholecystostomy for acute cholecystitis: a single-center experience. J Gastrointest Surg 2012; 16 (10) 1860-1868
• 3 Houghton PWG, Jenkinson LR, Donaldson LA. Cholecystectomy in the elderly: a prospective study. Br J Surg 1985; 72 (03) 220-222
• 4 Frazee RC, Nagorney DM, Mucha P Jr. Acute acalculous cholecystitis. Mayo Clin Proc 1989; 64 (02) 163-167
• 5 Saad WE, Wallace MJ, Wojak JC, Kundu S, Cardella JF. Quality improvement guidelines for percutaneous transhepatic cholangiography, biliary drainage, and percutaneous cholecystostomy. J Vasc Interv Radiol 2010; 21 (06) 789-795
• 6 Strasberg SM. Clinical practice. Acute calculous cholecystitis. N Engl J Med 2008; 358 (26) 2804-2811
• 7 Yokoe M, Hata J, Takada T. et al. Tokyo Guidelines 2018: diagnostic criteria and severity grading of acute cholecystitis (with videos).. J Hepatobiliary Pancreat Sci 2018; 25 (01) 41-54
• 8 vanSonnenberg E, D’Agostino HB, Goodacre BW, Sanchez RB, Casola G. Percutaneous gallbladder puncture and cholecystostomy: results, complications, and caveats for safety. Radiology 1992; 183 (01) 167-170
• 9 Venara A, Carretier V, Lebigot J, Lermite E. Technique and indications of percutaneous cholecystostomy in the management of cholecystitis in 2014. J Visc Surg 2014; 151 (06) 435-439