Percutaneous Cholecystostomy and Cholecystolithotomy

Abstract

Acute cholecystitis is a relatively common condition with high associated risk of morbidity and mortality. Symptomatic calculus cholecystitis generally requires treatment by early cholecystectomy under antibiotic prophylaxis and has been shown to be superior to delayed surgery in several prospective trials. Mortality can be as low as 0.5% in younger age groups, but in the elderly and critically ill, mortality can be higher (14–30%). In these latter groups, comorbid conditions can also delay surgery or make it impossible. This can lead to complications, such as systematic sepsis and gall bladder (GB) perforation. Percutaneous cholecystostomy (PC), which was initially described by Radder in 1980, can be a safer alternative in the high-risk patients. It can also be used to access the GB for other interventions such as cholecystolithotomy and stent placement.