AB105. SOH25_AB_226. Cholecystostomy drainage: current practices in a tertiary hepatobiliary unit
General Surgery III

AB105. SOH25_AB_226. Cholecystostomy drainage: current practices in a tertiary hepatobiliary unit

Mohammed Al Azzawi1,2, Carolyn Cullinane1,2, Constantine Manole2,3, Aidan Coffey2,3, Damien O’Neill3, Thomas Murphy1, Cristoir O’Sulleabhain1, Adrian O’Sullivan1

1Department of Surgery, Mercy University Hospital, Cork, Ireland; 2Department of Surgery, Royal College of Surgeons in Ireland, Dublin, Ireland; 3Department of Radiology, Mercy University Hospital, Cork, Ireland

Background: Acute calculous cholecystitis is a common general surgical emergency and accounts for 20% of symptomatic gallstone presentations. Severity is stratified into mild, moderate and severe according to the Tokyo Guidelines. Percutaneous cholecystostomy tubes (PCTs) serve as a temporary intervention in acutely unwell patient with gallbladder disease. The aim of this study is to assess the current utility of PCT’s in a tertiary hepatobiliary referral centre.

Methods: This is a retrospective review of patients with PCT in a tertiary hepatobiliary referral centre between January 2018 and December 2023. Clinical, radiological and perioperative outcomes were measured. Descriptive analysis was performed using GraphPad Prism program.

Results: Sixty-eight patients were identified over a 6-year period. The mean age was 71.6 years with a male majority. The inpatient referral group had a higher rate of the American Society of Anaesthesiologists (ASA) IV score (43%, n=18) compared to the external referral group (39%, n=7) (P=0.78). The commonest diagnosis was severe cholecystitis with septic shock (33.8%) followed by gall bladder perforation (26.4%). Complications occurred in 4.4% of cases and 61.7% of patients had a follow-up cholecystogram. The mean duration of PCT insertion was 95.78 days in our cohort. Completion cholecystectomy was performed in 87.1% in patients with ASA I–II and 40% in patients with ASA III–IV (P<0.05).

Conclusions: PCT is a safe and effective procedure in managing acutely unwell patients with severe cholecystitis. There is significant heterogeneity in the literature in relation to the management and follow-up guidelines of PCT. Future studies should focus on establishing best practice guidelines for PCT follow-up.

Keywords: Acute cholecystitis; cholecystograms; laparoscopic cholecystectomy; open cholecystectomy; percutaneous cholecystostomy tubes (PCTs)

Acknowledgments

None.

Footnote

Funding: None.

Conflicts of Interest: The authors have no conflicts of interest to declare.

Ethical Statement: The authors are accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved.

Open Access Statement: This is an Open Access article distributed in accordance with the Creative Commons Attribution-NonCommercial-NoDerivs 4.0 International License (CC BY-NC-ND 4.0), which permits the non-commercial replication and distribution of the article with the strict proviso that no changes or edits are made and the original work is properly cited (including links to both the formal publication through the relevant DOI and the license). See: https://creativecommons.org/licenses/by-nc-nd/4.0/.

doi: 10.21037/map-25-ab105
Cite this abstract as: Al Azzawi M, Cullinane C, Manole C, Coffey A, O’Neill D, Murphy T, O’Sulleabhain C, O’Sullivan A. AB105. SOH25_AB_226. Cholecystostomy drainage: current practices in a tertiary hepatobiliary unit. Mesentery Peritoneum 2025;9:AB105.

Article Options

Download Citation

Share