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. 2020 Sep;90(9):1660-1665.
doi: 10.1111/ans.15726. Epub 2020 Feb 20.

Short- and long-term outcomes of percutaneous cholecystostomy in an Australian population

Maria Julia Corbetta Machado  1 , Andrew Gray  1   2 , Marisol P Cerdeira  1   2 , Jon Gani  1   2
Affiliations

Short- and long-term outcomes of percutaneous cholecystostomy in an Australian population

Maria Julia Corbetta Machado et al. ANZ J Surg. 2020 Sep.

Abstract

Background: Percutaneous cholecystostomy (PC) is a well-recognized management option for the treatment of acute cholecystitis (AC) in high-risk patients. Patient characteristics, efficacy and particularly the longer-term outcomes for patients having PC across the Hunter New England Local Health District were analysed.

Methods: A retrospective audit from January 2013 to September 2017 was undertaken. Patients were followed up until September 2019. All were retrospectively risk assessed using the P-POSSUM risk assessment tool, complications and mortality were recorded. In addition to short-term data, longer-term outcomes including patient's living situation at 6 and 12 months were analysed.

Results: A total of 82 patients were assessed at ≥12 months post procedure or until death. Successful initial gallbladder drainage was achieved in 99% of cases. The mean P-POSSUM score for mortality was 11%, confirming that this is a high-risk group; 17% had inpatient complications recorded; 10% of these were major (Clavien-Dindo ≥III). Outpatient complications were seen in 45%, 59% underwent further biliary tree intervention and 24% had recurrent AC. Thirty-day mortality was 12% and 1-year mortality was 22%. Functional capacity changed significantly for 41% of patients at 1 year, with 12% requiring a new admission to high-level nursing home care.

Conclusion: Our series represents the largest reported Australasian series of PC for AC published to date. It confirms that PC is well-established and safe in high-risk patients. However, further intervention rates and recurrence rates of AC are high and escalation of dependency of care affects almost half of patients.

Keywords: acute cholecystitis; outcome; percutaneous cholecystostomy.

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