Percutaneous Cholecystostomy : 60 Cases of Experience

Kang, Sung Gwon; Song, Ho Young; Yoon, Hyun Ki; Lee, Young Suk; Kim, Won Woo; Sung, Gyu Bo

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 cholecystectomy :underlying 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.