Percutaneous Cholecystostomy:
an alternative therapy
in high-risk surgical patients
Berta Barbosa MD, Catarina Morais MD, Ezequiel Silva MD, Bruno Santos MD, Cecília Pinto MD, António
Canha MD, Paulo Soares MD, Donzília Sousa Silva MD MSc, Jorge Daniel MD, José Davide MD
Hepatobiliopancreatic Unit (Head: José Davide)
Centro Hospitalar do Porto, Hospital de Santo António, Porto, Portugal
Introduction
Percutaneous cholecystostomy is an alternative technique recommended in the management
of acute cholecystitis in high-risk surgical patients.
It can be considered an intermediate step for the definitive treatment of gallstones
complications.
Methods
Observational, retrospective study of patients undergoing percutaneous cholecystostomy in
the period between 1st January 2009 and 30th May 2014 - Total: 118 patients.
Early Morbidity
Age
Clinical Worsening
3
2,5%
Haemoperitoneum
2
1,7%
Perforation
1
0,8%
Biliary Peritonitis
5
4,2%
Recurrence
6
5,1%
2
1,7%
Late Morbidity
Mortality
Drainage: 13,2 days
[3-38]
MOD; aspiration pneumonia
Percutaneous Cholecystostomy
Urgent Cholecystectomy: 6 (5,1%)
Endoscopic
Sphincterotomy: 9 (7,6%)
Surgery: 3
Early Cholecystectomy: 19 (16,1%)
Delayed Cholecystectomy: 27 (22,9%)
Non Operated: 57 (48,3%)
Acalculous: 14
2 deaths
Calculous: 43
Recurrence of Acute
Cholecistitis: 3 (5,2%)
Discussion
In some patients not eligible for surgery, percutaneous cholecystostomy is an alternative and valuable
therapeutic modality to manage acute cholecystitis.
References:
1. Welschbillig-Meunier K, et al (2005). Percutaneous cholecystostomy for high-risk patients with acute cholecystitis. Surg Endosc, 19: 1256-9.
2. Akyürek N, et al (2005). Management of Acute Calculous Cholecystitis in High-Risk Patients Percutaneous Cholecystotomy Followed by Early Laparoscopic Cholecystectomy.
Surg Laparosc Endosc Percutan Tech, 15 (6): 315-20.