Clinical StudyOutcomes of Percutaneous Cholecystostomy in the Presence of Ascites
Section snippets
Patient Selection and Data Collection
In accordance with the institutional review board, a retrospective review of all patients who underwent a transhepatic percutaneous cholecystostomy procedure from January 2005 until June 2014 at an academic medical center was performed by examining the records from a dedicated interventional radiology database (HI-IQ; ConexSys, Lincoln, Rhode Island). In total, 255 patients were identified. All catheters were placed by interventional radiologists (mean experience, 12 y; range, 1–22 y) with
Results
The overall incidences of PCT complications were similar between the two groups. Complications occurred in 11% of patients with ascites (n = 11) compared with 10% of those without ascites (n = 16; P = .834). No difference was found between the two groups for any one type of complication. The incidences and types of complication for patients with and without ascites are further detailed in Table 3. Analysis of complications was also performed when only diffuse ascites was categorized as ascites
Discussion
Percutaneous cholecystostomy procedures have become an accepted technique for the management of clinically diagnosed acute cholecystitis in patients with extensive comorbidities or temporary high-risk factors that may make surgical intervention suboptimal (2, 3, 7, 8, 9, 10). Ascites has been cited as a potential factor that may lead to increased risk of complications in PCT, although there few studies addressing this hypothesis (3, 4). Increased mobility of the PCT and/or failure of a
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Cited by (15)
Call for action: Increased healthcare utilization with growing use of percutaneous cholecystectomy tube over initial cholecystectomy in cirrhotics
2022, Hepatobiliary and Pancreatic Diseases InternationalCitation Excerpt :PCT has additionally been shown to be effective in cirrhotics with ascites, which was considered a relative contraindication in the past [8]. This procedure can provide patients with decompression of their biliary system, typically within a few days, reduce overall complications of ACC, and allow time to optimize cirrhotic patients for definitive surgery [7–9]. However, in the general population, PCT typically leads to multiple readmissions, prolonged hospital stays, and higher hospital costs when it is not followed by definitive management [8–10].
Society of Interventional Radiology Quality Improvement Standards for Percutaneous Cholecystostomy and Percutaneous Transhepatic Biliary Interventions
2020, Journal of Vascular and Interventional RadiologyCitation Excerpt :Ascites has historically represented a relative contraindication to percutaneous access to the biliary system or cholecystostomy owing to increased risk of bleeding and pericatheter leakage (54). Paracentesis may be performed simultaneously with the biliary intervention to mitigate some of this risk at some practices; however, a recent retrospective study suggests that ascites does not represent an increased risk to the patient with cholecystostomy (54). Decreasing the amount of ascites for percutaneous transhepatic cholangiography can be helpful in reducing radiation dose.
Percutaneous cholecystostomy as treatment for acute cholecystitis: What has happened over the last five years? A literature review
2019, Revista de Gastroenterologia de MexicoAssessment of Gallbladder Drainage Methods in the Treatment of Acute Cholecystitis: A Literature Review
2024, Medicina (Lithuania)Percutaneous cholecystostomy: techniques and applications
2023, Abdominal Radiology
None of the authors have identified a conflict of interest.
Table E1 is available online at www.jvir.org.