Introduction
The role of percutaneous cholecystostomy (PC) in the management of patients with acute
calculous cholecystitis (ACC) remains controversial. The aim of this study is to report
operative outcomes in a large cohort of patients undergoing PC before their delayed
laparoscopic cholecystectomy (DLC).
Methods
All patients who underwent DLC because of ACC between 2003 and 2012 were included.
Outcomes of patients with and without previous PC were compared.
Results
Of 639 patients who underwent DLC because of ACC at our institution during a 10-year
time interval beginning 2003, 163 (25.5%) patients had PC before their DLC. Patients
who underwent PC were older (64 ± 1 years vs 48 ± 0.8 years, P < .001) and had more comorbid conditions (P < .001). Accumulated duration of stay was longer in the PC group (16.2 ± 0.4 days
vs 9.7 ± 0.1 days, P < .001). Rate of conversion to open procedure was greater in the PC group (11% vs
4%, P = .001) and operative time was longer (142 ± 4 minutes vs 107 ± 4 minutes, P < .001). Patients in the PC group had a greater rate of biliary-related complications
(10% vs 4%, P = .003) and surgical-site infections; both superficial (5% vs 1%, P = .004) and deep (7% vs 3%, P = .04). On multivariable analysis PC was an independent risk factor for conversion
to open cholecystectomy (odds ratio 2.67 95% CI 1.18–6.72) as well as to biliary-related
complications (odds ratio 4.85 95% CI 1.57–14.92).
Conclusion
DLC for ACC in patients with previous PC is associated with longer duration of stay,
more readmissions, and, most importantly, greater conversion rate, biliary related
complications, and surgical-site infections.
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Article info
Publication history
Published online: June 17, 2015
Accepted:
May 9,
2015
Footnotes
Ido Mizrahi and Haggi Mazeh contributed equally to the preparation of the manuscript.
Identification
Copyright
© 2015 Elsevier Inc. Published by Elsevier Inc. All rights reserved.
