The role of percutaneous cholecystostomy in the treatment of acute cholecystitis

INTRODUCTION AND AIM: Percutaneous cholecystostomy (P.C.) is the insertion of a catheter into the gallbladder lumen under imaging guidance. P.C. can be curative in the treatment of acute cholecystitis (A.C.), or it can be performed as a bridging treatment in patients who will undergo surgery. In our study, we investigated the effect of the P.C. on patients' clinical and laboratory findings. MATERIAL AND METHOD: In our study, 36 patients were included, who underwent P.C. between February 2017 and November 2018 in the interventional radiology department. The clinical and laboratory findings of the patients before and after the procedure were reviewed retrospectively. RESULTS: No recurrence was observed in our patients. The duration of catheterization was 50.2 ± 26.1 days, and the hospital stay was 7.5 ± 5.2 days. A statistically significant difference was found between pre- and post-procedure in the number of patients with high total bilirubin and white blood cell (WBC) values (p<0.05). Another statistically significant difference was also found between the values of ALT, ALP, CRP, WBC, total and direct bilirubin parameters before and after the procedure (p<0.05). It was found that the duration of catheterization of the group that showed symptomatic improvement after the procedure was longer than the group that did not show improvement (p<0.05). It was observed that the duration of hospital stay of male patients was longer. A statistically significant difference was found between the Tokyo guideline stage and the need for intensive care unit (p<0.05), and all patients treated in the intensive care unit were stage 3. The mean age of the patients who were admitted to the intensive care unit was statistically higher than those who were not admitted (p<0.05). The mean age of patients who underwent surgery after P.C. was higher than the other group (p<0.05). CONCLUSIONS: Significant decrease in WBC and CRP value after the procedure and clinical improvement in the majority of patients show that P.C. positively affects inflammatory processes related with A.C. In our study, a significant decrease was found in ALT and ALP values after the procedure, and according to our knowlodge, this finding was described for the first time in the literature.