Percutaneous Cholecystostomy : 60 Cases of Experience

ABSTRACT

PURPOSE: To review the effectiveness and complication of percutaneous cholecystostomy(PCCS). MATERIALS AND METHODS: We performed PCCS in 60 patient who presented with acute cholecystitis. The causes of acutecholecystitis were as follows acalculous cholecystitis(n=8), calculous cholecystitis(n=23), GB hydrops(n=3), GBempyema(n=15), septic cholangitis(n=11). Of 60 patients, 36 patients had high risk factor for cholecystectomyunderlying malignancy(n=13), severe trauma(n=2), liver cirrhosis(n=3), diabetes mellitus(n=6), end stage renal disease(n=3), cardiac disease(n=3) and others(n=6). Cholecystostomy was done under ultrasonographic and fluoroscopic guide. RESULTS: The cholecystostomy was successfully in 59 patients, and failed in 1 patients. 15 patients improved without other procedure. 16 patients underwent cholecystectomy after improvement of their general condition. Severe complications of PCCS are as follows bile peritonitis(n=6), hemoperitoneum(n=1), subphrenic abscess(n=1). Mild complication, such as pain, occured in most patients. Emergency operation was done in one patient who developed bile peritonitis. DISCUSSION: Cholecystostomy is effective and safe, especially incases of in operable patients who represent acute cholecystitis. Percutaneous cholecystostomy may substitiute surgical cholecystostomy.