Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Multicenter Study
. 2024 Oct;38(10):6053-6059.
doi: 10.1007/s00464-024-11145-7. Epub 2024 Aug 12.

Multisociety research collaboration: timing of cholecystectomy following cholecystostomy drainage for acute cholecystitis

Konstantinos Spaniolas  1 , Aurora Pryor  2 , Dimitrios Stefanidis  3 , Spyridon Giannopoulos  3 , Preston R Miller  4 , Audrey L Spencer  5 , Salvatore Docimo  6 , Christopher DuCoin  6 , Samuel W Ross  7 , Lynnette Schiffern  7 , Caroline Reinke  7 , William Sherrill  7 , Jeffry Nahmias  8 , Morgan Manasa  8 , Tammy Kindel  9 , Deemantha Wijekulasooriyage  9 , Luca Cardinali  10 , Salomone Di Saverio  10 , Jie Yang  11 , Yunhan Liao  11
Affiliations
Multicenter Study

Multisociety research collaboration: timing of cholecystectomy following cholecystostomy drainage for acute cholecystitis

Konstantinos Spaniolas et al. Surg Endosc. 2024 Oct.

Abstract

Background: Patients with acute cholecystitis (AC) presenting with unfavorable systemic or local conditions are often managed with percutaneous cholecystostomy (PC) as a temporary measure. The clinical outcomes of interval cholecystectomy following PC remain unclear. The aim of the study was to identify the association between the timing of cholecystectomy following PC for AC and perioperative complication rates at interval cholecystectomy. We hypothesized that there would be a specific time interval to cholecystectomy associated with lower risk for adverse events.

Methods: This was a retrospective (2018-2020) multicenter study at 8 participating hospital systems of adult patients with AC, managed with PC and interval cholecystectomy. Demographics, comorbidities, treatment details, and outcomes were examined. Patients were grouped based on quartiles for timing of surgery after PC (< 7, 7-9, 10-13, > 13 weeks). The primary outcome was a composite endpoint of bile duct injury, reoperation, readmission, image-guided intervention, endoscopic intervention, conversion to open surgery, or death.

Results: There were 188 patients with a median age of 66 years with AC classified as mild (41%), moderate (47%), and severe (12%). Median days from PC to surgery were 65 (Q1 = 48, Q3 = 91). Laparoscopic cholecystectomy (89.9%) was the most commonly planned approach (robotic 6.4%, 3.7% open) and 28 (14.9%) were converted to open. The composite endpoint was reported in 51 patients (27.1%). A biliary injury occurred in 7 (3.7%) patients. Time to surgery and intraoperative drain placement were independently associated with the composite outcome. Cholecystectomy within 7 weeks of PC was associated with decreased risk (OR = 0.36, 95% CI 0.13-0.97) of the composite endpoint, compared to patients undergoing surgery > 13 weeks after PC.

Conclusion: Timing of surgery following PC was associated with procedural outcomes. Patients undergoing surgery before 7 weeks experienced significantly less morbidity than patients having delayed cholecystectomy. These results should be considered in patient selection and management after PC.

Keywords: Acute cholecystitis; Cholecystectomy; Cholecystostomy; Interval cholecystectomy.

PubMed Disclaimer

References

    1. Fingar KR, Stocks C, Weiss AJ et al (2006) Most frequent operating room procedures performed in U.S. Hospitals. Healthcare cost and utilization project (HCUP) statistical briefs. Agency for Healthcare Research and Quality, Rockville, pp 2003–2012
    1. Wadhwa V, Jobanputra Y, Garg SK, Patwardhan S, Mehta D, Sanaka MR (2017) Nationwide trends of hospital admissions for acute cholecystitis in the United States. Gastroenterol Rep 5(1):36–42. https://doi.org/10.1093/gastro/gow015 - DOI
    1. Tan HY, Jiang DD, Li J, He K, Yang K (2018) Percutaneous transhepatic gallbladder drainage combined with laparoscopic cholecystectomy: a meta-analysis of randomized controlled trials. J Laparoendosc Adv Surg Tech A 28(3):248–255. https://doi.org/10.1089/lap.2017.0514 - DOI - PubMed
    1. Altieri MS, Bevilacqua L, Yang J, Yin D, Docimo S, Spaniolas K, Talamini M, Pryor A (2019) Cholecystectomy following percutaneous cholecystostomy tube placement leads to higher rate of CBD injuries. Surg Endosc 33(8):2686–2690. https://doi.org/10.1007/s00464-018-6559-4 - DOI - PubMed
    1. Inoue K, Ueno T, Nishina O, Douchi D, Shima K, Goto S, Takahashi M, Shibata C, Naito H (2017) Optimal timing of cholecystectomy after percutaneous gallbladder drainage for severe cholecystitis. BMC Gastroenterol 17(1):71. https://doi.org/10.1186/s12876-017-0631-8 - DOI - PubMed - PMC

Publication types

LinkOut - more resources