Evaluating the Controversial Role of Cholecystostomy in Current Clinical Practice

Percutaneous cholecystostomy (PC) for the treatment of acute cholecystitis is increasing in popularity, and has served as a definitive treatment, a bridge to surgery, or a means toward other minimally invasive therapies. The absence of quality literature supporting a clear definition of the role of PC and related adjunctive therapies in the treatment of acute cholecystitis often results in inconsistent application of this treatment option in clinical practice. Because excellent overviews of the technique of PC and associated clinical management have been published recently,[1] this article focuses on the controversial indications, complications, and evolving roles of percutaneous cholecystostomy and related therapies.

REFERENCES

• 1 Ginat D, Saad WEA. Cholecystostomy and transcholecystic biliary access.  Tech Vasc Interv Radiol. 2008;  11 (1) 2-13
• 2 Saad WEA, Wallace M J, Wojak J C, Kundu S, Cardella J F. Quality improvement guidelines for percutaneous transhepatic cholangiography, biliary drainage, and percutaneous cholecystostomy.  J Vasc Interv Radiol. 2010;  21 (6) 789-795
• 3 Winbladh A, Gullstrand P, Svanvik J, Sandström P. Systematic review of cholecystostomy as a treatment option in acute cholecystitis.  HPB (Oxford). 2009;  11 (3) 183-193
• 4 Lujan J A, Parrilla P, Robles R, Marin P, Torralba J A, Garcia-Ayllon J. Laparoscopic cholecystectomy vs open cholecystectomy in the treatment of acute cholecystitis: a prospective study.  Arch Surg. 1998;  133 (2) 173-175
• 5 Skillings J C, Kumai C, Hinshaw J R. Cholecystostomy: a place in modern biliary surgery?.  Am J Surg. 1980;  139 (6) 865-869
• 6 Kiviluoto T, Sirén J, Luukkonen P, Kivilaakso E. Randomised trial of laparoscopic versus open cholecystectomy for acute and gangrenous cholecystitis.  Lancet. 1998;  351 (9099) 321-325
• 7 Houghton P W, Jenkinson L R, Donaldson L A. Cholecystectomy in the elderly: a prospective study.  Br J Surg. 1985;  72 (3) 220-222
• 8 Welschbillig-Meunier K, Pessaux P, Lebigot J et al.. Percutaneous cholecystostomy for high-risk patients with acute cholecystitis.  Surg Endosc. 2005;  19 (9) 1256-1259
• 9 Chung Y H, Choi E R, Kim K M et al.. Can percutaneous cholecystostomy be a definitive management for acute acalculous cholecystitis?.  J Clin Gastroenterol. 2011;  epub ahead of print
• 10 Kim Y H, Kim Y J, Shin T B. Fluoroscopy-guided percutaneous gallstone removal using a 12-Fr sheath in high-risk surgical patients with acute cholecystitis.  Korean J Radiol. 2011;  12 (2) 210-215
• 11 Courtois C S, Picus D D, Hicks M E et al.. Percutaneous gallstone removal: long-term follow-up.  J Vasc Interv Radiol. 1996;  7 (2) 229-234
• 12 Petroni M L, Jazrawi R P, Pazzi P The British-Italian Gallstone Study Group et al. Risk factors for the development of gallstone recurrence following medical dissolution.  Eur J Gastroenterol Hepatol. 2000;  12 (6) 695-700
• 13 Carrilho-Ribeiro L, Pinto-Correia A, Velosa J, de Moura M C. Long-term gallbladder stone recurrence and risk factors after successful lithotripsy.  Eur J Gastroenterol Hepatol. 2000;  12 (2) 209-215
• 14 Xu Z, Wang L, Zhang N, Ling X, Hou C, Zhou X. Chemical ablation of the gallbladder: clinical application and long-term observations.  Surg Endosc. 2005;  19 (5) 693-696
• 15 Ito K, Fujita N, Noda Y et al.. Percutaneous cholecystostomy versus gallbladder aspiration for acute cholecystitis: a prospective randomized controlled trial.  AJR Am J Roentgenol. 2004;  183 (1) 193-196
• 16 Chopra S, Dodd III G D, Mumbower A L et al.. Treatment of acute cholecystitis in non-critically ill patients at high surgical risk: comparison of clinical outcomes after gallbladder aspiration and after percutaneous cholecystostomy.  AJR Am J Roentgenol. 2001;  176 (4) 1025-1031