Percutaneous Cholecystostomy to Manage a Hot Gallbladder: A Single Center Experience

Mohit Bhatia; Bindhiya Thomas; Elia Azir; Doaa Al-Maliki; Khalid Ballal; Priyan Tantrige; Gibran Timothy Yusuf; Shamsi El-Hasanii

doi:10.7759/cureus.45348

Percutaneous Cholecystostomy to Manage a Hot Gallbladder: A Single Center Experience

Cureus. 2023 Sep 16;15(9):e45348. doi: 10.7759/cureus.45348. eCollection 2023 Sep.

Authors

Mohit Bhatia¹, Bindhiya Thomas¹, Elia Azir¹, Doaa Al-Maliki¹, Khalid Ballal², Priyan Tantrige², Gibran Timothy Yusuf², Shamsi El-Hasanii³

Affiliations

¹ Surgery, Princess Royal University Hospital, King's College Hospital NHS Foundation Trust, London, GBR.
² Intervention Radiology, Princess Royal University Hospital, King's College Hospital NHS Foundation Trust, London, GBR.
³ Upper Gastrointestinal Surgery, Princess Royal University Hospital, King's College Hospital NHS Foundation Trust, London, GBR.

Abstract

Objective A percutaneous cholecystostomy (PC) is a suitable option for treating acutely inflamed gallbladders. Its use has been postulated before for treating acute cholecystitis (AC), especially in elderly populations. The primary aim of our study is to analyze and present the positive results of PC as a bridge to laparoscopic cholecystectomy. Methods All patients who underwent PC at our hospital, Princess Royal University Hospital, King's College Hospital NHS Foundation Trust, London, GBR, from October 2020 were reviewed using a retrospective approach. Results Our study comprises 123 patients, with 72 females (58.5%) and 51 males (41.4%). In our study, many patients had significant comorbidities, and some of them were categorized as high-risk due to their frailty and medical conditions. The majority of the patients were in American Society of Anaesthesiologists' (ASA) groups II and III (45, 61), respectively. Though hospital stays can depend on variable factors, in our experience, the mean hospital length of stay was 12.7 days. In our study, 119 patients (96.8%) had the procedure through the interventional radiological approach, while only four patients had it through the laparoscopic approach. The transhepatic route for drainage was more commonly practiced at our center and was used in 108 patients. At the time of writing this article, 54 patients have already had a laparoscopic cholecystectomy (LC) done as an interval procedure after surpassing the acute attack of cholecystitis, while 42 patients are still awaiting their surgical procedure. Conclusion Our results show that PC is a viable option, especially in cases of AC that are not responding to conservative treatments. Our study has shown low complications and conversion rates after PC. We believe PC is a safe and effective tool for managing severe and refractory cases of AC.

Keywords: acute calculus cholecystitis; conventional laparoscopic cholecystectomy; minimally invasive interventional radiology; percutaneous biliary drainage; percutaneous cholecystostomy tube.