Treatment of perforated acute cholecystitis with percutaneous cholecystostomy

Acute cholecystitis is a common disease treated with laparoscopic cholecystectomy as a standard procedure. Perforated cholecystitis is a complication of acute cholecystitis and patients with comorbidities who have a high risk for the operation may also be treated with percutaneous cholecystostomy. The procedure may also be applied for the selected patients with perforated cholecystitis who have a delayed admission to the health institution or who are irresponsive to antibiotherapy. The aim of the present study is to investigate the clinical outcomes and data of the acute cholecystitis patients who underwent percutaneous cholecystostomy. Twentyfour patients who underwent percutaneous cholecystostomy with the diagnosis of perforated acute calculous cholecystitis between October 2012 and February 2020 were included in the study. Diagnosis of acute cholecystitis was made based on the Tokyo Criteria. Patient data were reached through a retrospective screening. Of the total of 24 patients, 70.8% were males. Mean age was 63.3±12.9 years and mean duration of hospital stay was 13.0±9.4 days. All patients were grade 2 according to Tokyo 2018 severity stratification. Mean duration of catheter stay was 37.7±25.3 days. Fifteen patients (62.5%) underwent cholecystectomy. Ratio of complications was 16.7% and catheter dislocation (n=2) was the most common complication. Mean duration of follow-up was 1 year. No patients developed acute cholecystitis on follow-ups, one patient developed acute cholangitis. Mortality rate was calculated for 60 days and no mortality was detected. High risk patients with comorbid conditions may be safely treated with percutaneous cholecystostomy as perforated cholecystitis increases mortality and morbidity in patients with acute cholecystitis.

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