Ultrasound-guided percutaneous cholecystostomy in high-risk surgical patients

Langenbecks Arch Surg. 2001 Apr;386(3):212-7. doi: 10.1007/s004230100211.


Background and aims: In critically ill patients, cholecystectomy is associated with a high mortality rate. The aim of this study was to evaluate the safety, efficacy and long-term outcome of ultrasound-guided percutaneous cholecystostomy (USGPC) in critically ill patients with acute cholecystitis.

Materials and methods: Clinical records of 51 patients, all considered high-risk surgical patients, with acute cholecystitis treated with USGPC between 1987 and 1999, were retrospectively reviewed. Response was defined as improvement in clinical symptoms and signs, and/or reduction in c-reactive protein and white blood count levels within 72 h. Long-term results were evaluated by means of clinical records and written correspondence.

Results: Gallbladder stones were seen in 28 patients whereas 23 had acalculous cholecystitis. Ninety percent showed clinical improvement after USGPC. Cholecystectomy was performed in 16%, of which 6% after recurrent cholecystitis. Recurrence of cholecystitis occurred in 22%. Hospital mortality was 16%. None of the deaths was procedure related or related to acute cholecystitis alone. Major complications relating to the USGPC were rare (4%), while minor catheter-related complications were quite common.

Conclusions: USGPC is a procedure with few complications and a high success rate. In patients with acalculous cholecystitis as well as in many patients with calculous cholecystitis, no further treatment was needed.

MeSH terms

  • Aged
  • Cholecystitis / diagnostic imaging*
  • Cholecystitis / surgery*
  • Cholecystostomy / methods*
  • Cholelithiasis / diagnostic imaging
  • Cholelithiasis / surgery
  • Female
  • Humans
  • Male
  • Retrospective Studies
  • Risk Assessment
  • Safety
  • Treatment Outcome
  • Ultrasonography