Percutaneous cholecystostomy in non-surgical patients

Purpose. To assess the efficacy and complications of percutaneous cholecyst ostomy (PC) in the treatment of acute cholecystitis in non-surgical patient s. Materials and methods: Retrospective study of 25 cases (16 males and 9 fema les) of PC. The average age was 82 years (range: 59-95). Eight had acute ac alculous cholecystitis (AAC) and 17 had acute calculous cholecystitis (ACC) . US-guided percutaneous cholecystostomy was performed in most cases; CT-gu idance was required in 5 cases. Results. One technical failure and one complication (abdominal wall hematom a) occurred. PC was successful for sepsis control in 21 patients (5 AAC and 16 ACC): delayed cholecystectomy was performed in one patient, and one pat ient had recurrent acute cholecystitis at one month that responded to medic al management. For the 4 remaining patients: 1 corresponded to the technica l failure, and failure of sepsis control was observed in the 3 others patie nts (2 AAC, 1 ACC). PC was the definitive treatment or resulted in sepsis c ontrol in 84% of cases. PC was the definitive treatment, without recurrence , in 76% of cases. Conclusion. US or CT guided percutaneous cholecystostomy is an effective tr eatment, with a low rate of complication, in elderly or critically ill pati ents. PC can be used as a definitive treatment or as a temporizing measure in critically ill patients allowing for delayed definitive surgical/endosco pic management.