Percutaneous cholecystostomy for acute cholecystitis in veteran patients

BACKGROUND: Surgical cholecystostomy has been shown to carry a significantl y higher mortality rate at Veterans Administration (VA) hospitals than at n on-federal hospitals in the past. METHODS: A retrospective outcomes study was undertaken at a large VA medica l center with a policy favoring radiologic over surgical cholecystostomy ov er the past 9 years. Records of 24 consecutive patients with acute cholecys titis were reviewed to evaluate the effectiveness of the procedure. RESULTS: Cholecystostomy was performed radiologically in 22 patients and su rgically in 2 patients. Most (78%) of patients improved within 48 hours. Th e periprocedural mortality was 25%. The majority of these patients died fro m unrelated illnesses. Four patients developed complications, none of which required operative intervention. CONCLUSIONS: Comorbidities are the most important mortality factor for chol ecystostomies in VA patients. Radiologic tube placement is effective and un complicated in most cases. Am J Surg. 2000;180:198-202. (C) 2000 by Excerpt a Medica, Inc.