Percutaneous transhepatic cholecystostomy performed with the trocar technique using ultrasonography: Evaluation of the effectiveness and reliability with laboratory and clinical parameters

The aim of this study was to evaluate the effectiveness and postoperative complications of percutaneous cholecystostomy with the trocar method and transhepatic approach in 76 patients who applied to Eskişehir Osmangazi Medical Faculty Hospital due to acute cholecystitis and were treated with percutaneous cholecystostomy with the trocar method and transhepatic approach. No bleeding was observed in any patients after the procedure, however, catheter malposition was detected in 4 patients. The patients in the study were divided into two groups as ward patients who died in the early postprocedural period and patients who were discharged after a period of ward monitoring. Between those two groups; the differences in culture results, gallbladder volume at admission, pre- and post-procedural CRP, procalcitonin and leukocyte values were investigated. A statistically significant difference was found when the CRP and procalcitonin values of the patient groups were compared. In the ROC curve analysis of the postoperative CRP values in two patient groups, CRP value of 35 (mg/l) had sensitivity of 80% and specifity of 76% for distinguishing the two groups. In the ROC curve analysis of procalcitonin, the value of 0.54 (ng/ml) had 70% sensitivity and 86% specificity to distinguish these two patient groups. In patients discharged after the ward monitoring period, the effect of the presence or absence of stones in the gallbladder on the duration of catheter stay was investigated, however, no statistically significant difference was found. In patients discharged after the ward monitoring process, the relationship between antibiotic administration via drainage catheter in the procedure and catheter diameter with the duration of catheter stay was also examined, however,no statistically significant relationship was found. Key Words:Cholecystitis, percutaneous cholecystostomy, ultrasonography