Should cholangiography be part of the management of every patient with percutaneous cholecystostomy?

Abstract

Introduction: Percutaneous cholecystostomy (PCC) is a well-established treatment in patients with high surgical risk and those who failed conservative treatment. However, the role of cholangiography in the management of PCC patients is not clear. In our medical center, cholangiography is routinely performed before discharging patient with PCC. We aimed to evaluate the utility of this test and its effect on the patient's management.

Methods: The study included all patients managed with PCC between 2015 to 2017. The patients were divided to those with positive findings and those with no findings. The two groups were compered in demographical and clinical parameters.

Results: 119 patients underwent PCC during the study period. Indication for PCC were comorbidities in 73% and failure of conservative treatment in 27%. Cholangiography was performed in 95 patients. Third of the patients had positive findings in their cholangiography. 13 patients had CBD stones, 14 had obstruction of gallbladder and 6 had bile leak. All positive findings required changed in management.

Conclusion: PCC is a safe procedure. Cholangiography, should be performed in every patient who was managed by PCC since it might change the management in third of the cases.

Keywords: Acute cholecystitis; Cholangiography; PCC; Percutaneous cholecystostomy.