Use of percutaneous cholecystostomy for complicated acute lithiasic cholecystitis: solving or deferring the problem?

World Congress on SURGERY, SURGEONS AND ANESTHESIA

November 29-30, 2021 Webinar

Adnan Malik

University Hospital Coventry and Warwickshire, UK

Scientific Tracks Abstracts: J Surgery

Abstract :

Aim: To assess the short and long-term outcomes of patients who had percutaneous cholecystostomy insertion due to severe lithiasic cholecystitis, aiming to define areas for improvement. Methods: Retrospective review of our institutional practice including all patients who had a percutaneous cholecystostomy for complex lithiasic cholecystitis, over a 5-year period, allowing for an additional 1-year follow up. Results: A total of 34 patients were included. Percutaneous cholecystostomy insertion enabled quick and efficient control of the source of biliary sepsis without major procedural complications in all cases. In 14 (41.2%) patients, cholecystostomy alone served as definitive treatment, while in 20 (58.9%) cases it was used as bridging strategy for delayed elective cholecystectomy. In the delayed cholecystectomy group of patients, we noted a high conversion rate from laparoscopic to open surgery rate of 70%, with an overall subtotal cholecystectomy rate of 60%. Conclusion: Percutaneous cholecystostomies should be reserved only for complex lithiasic cholecystitis patients who are unwilling and/or unfit for surgery. We advocate the performance of upfront emergency cholecystectomy in any other case with liberal use of operative bail-out strategies, as a delayed elective operation is anyway likely to be converted to open and/or subtotal cholecystectomy.
Recent Publications
Malik A et al. Single-centre experience of emergency hernia surgery during COVID-19 pandemic. Med Glas (Zenica) 2021 Aug 1;18(2):463-467
Malik A et al. A man with suprapubic and scrotal ecchymosis. J Am Coll Emerg Physicians Open. 2021 May 1;2(3):e12431.
Seretis C, Malik A et al. Perioperative Intraperitoneal Chemotherapy for Peritoneal Surface Malignancies. J Clin Med Res 2020 Dec;12(12):773-779
Malik A et al. An elderly woman with intermittent and progressive abdominal pain. J Am Coll Emerg Physicians Open. 2021 Jul 31;2(4):e12504.
Seretis C, Malik A et al. Percutaneous Retroperitoneoscopic Drainage of Complex Extraperitoneal Abscesses Using Flexible Endoscopy: Chirurgia (Bucur) Nov-Dec 2020;115(6):792-797.

Biography :

Adnan Malik is a surgical trainee at University Hospitals Coventry and Warwickshire NHS Trust. He is a member of the Royal College of Surgeons of England and has also completed a bachelor of medical science from the University of Nottingham in which his dissertation was on enhanced recovery of surgery. He has a keen interest in surgical academia and has published widely on a range of topics.