Alternative application of percutaneous cholecystostomy in patients with biliary obstruction

• Published in: Abdominal imaging Vol. 46; no. 6; pp. 2891 - 2899
• Main Authors: Chung, Hung-Yu, Hsu, Chih-Chieh, Hung, Yu-Liang, Chen, Huan-Wu, Wong, Man Si, Fu, Chih-Yuan, Tsai, Chun-Yi, Chen, Ming-Yang, Wang, Shang-Yu, Hsu, Jun-Te, Yeh, Ta-Sen, Yeh, Chun-Nan, Jan, Yi-Yin
• Format: Journal Article
• Language: English
• Published: New York Springer US 01.06.2021; Springer Nature B.V
• Subjects: Bile ducts; C-reactive protein; Cholangitis; Cholecystectomy; Cholecystitis; Gallbladder diseases; Gastroenterology; Gastrointestinal surgery; Hepatobiliary; Hepatology; Imaging; Intestinal obstruction; Jaundice; Leukocytes; Malignancy; Medicine; Medicine & Public Health; Pancreatic cancer; Patients; Radiology; Surgical anastomosis; Obstructive jaundice; Bile duct obstruction; Cholecystostomy; Pancreatic neoplasms; Cholangitis
• ISSN: 2366-004X; 2366-0058; 2366-0058
• DOI: 10.1007/s00261-020-02898-5

Purpose Percutaneous cholecystostomy (PC) is an important modality for acute cholecystitis and has been applied for other clinical scenarios as well. In the present study, we aimed to investigate an alternative use of PC for obstructive jaundice. Methods From January 2012 to December 2018, eligible subjects were selected from patients undergoing PC in our institute. The characteristics, spectrum of underlying disease, indication for PC performance, details of the procedure, and treatment effect were all investigated. Results During the study period, 1364 patients underwent PC. Seventy patients fulfilled the defined inclusion criteria. While 47 patients were diagnosed with malignant biliary obstruction with or without cholangitis, 23 patients were diagnosed with nonmalignant biliary obstruction and acute cholangitis. There were 63 patients (90%) diagnosed with acute cholangitis. Pancreatic cancer ( n  = 24, 51%) and advanced malignancy ( n  = 28, 59%) were noted mostly in the group with malignant biliary obstruction. Treatment effects were proven by laboratory data, including the white blood cell count, C-reactive protein level, and hepatic function. Conclusion PC can temporize definitive therapies and serve as an alternative treatment for patients with nonmalignant conditions. For patients with advanced malignancy, PC can serve as a palliative procedure that has a high success rate and low complication rate and effectively relieves biliary obstruction.