Panamerican Journal of Trauma, Critical Care & Emergency Surgery

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VOLUME 11 , ISSUE 3 ( September-December, 2022 ) > List of Articles


The use of Percutaneous Tubes for Management of Acute Cholecystitis

Erik J Teicher, Paula A Ferrada

Keywords : Acalculous, Calculous, Cholecystectomy, Cholecystitis, Cholecystostomy, Gallbladder, Gallstones

Citation Information : Teicher EJ, Ferrada PA. The use of Percutaneous Tubes for Management of Acute Cholecystitis. Panam J Trauma Crit Care Emerg Surg 2022; 11 (3):145-150.

DOI: 10.5005/jp-journals-10030-1397

License: CC BY-NC 4.0

Published Online: 31-12-2022

Copyright Statement:  Copyright © 2022; The Author(s).


Percutaneous cholecystostomy (PC) tubes have been used in the management of acute cholecystitis (AC) as an alternative to cholecystectomy for decades. We place the management of AC into a structure based on the Tokyo guidelines. We then generally review the PC tubes and their appropriateness in the treatment of AC. Finally, we provide an algorithm when approaching patients with AC. This is an important topic as it is one of the common problems encountered in acute care surgery. Standardization of the care we provide to these patients can only lead to improved outcomes.

  1. Indar AA, Beckingham IJ. Acute cholecystitis. BMJ 2002;325(7365):639–643. DOI: 10.1136/bmj.325.7365.639
  2. Everhart JE, Khare M, Hill M, et al. Prevalence and ethnic differences in gallbladder disease in the United States. Gastroenterology 1999;117(3):632–639. DOI: 10.1016/s0016-5085(99)70456-7
  3. Cafasso DE, Smith RR. Symptomatic cholelithiasis and functional disorders of the biliary tract. Surg Clin North Am 2014;94(2):233–256. DOI: 10.1016/j.suc.2013.12.001
  4. Shaffer EA. Epidemiology and risk factors for gallstone disease: has the paradigm changed in the 21st century? Curr Gastroenterol Rep 2005;7(2):132–140. DOI: 10.1007/s11894-005-0051-8
  5. Gallaher JR, Charles A. Acute cholecystitis: a review. JAMA 2022;327(10):965–975. DOI: 10.1001/jama.2022.2350
  6. Treinen C, Lomelin D, Krause C, et al. Acute acalculous cholecystitis in the critically ill: risk factors and surgical strategies. Langenbecks Arch Surg 2015;400(4):421–427. DOI: 10.1007/s00423-014-1267-6
  7. Trowbridge RL, Rutkowski NK, Shojania KG. Does this patient have acute cholecystitis? JAMA 2003;289(1):80–86. DOI: 10.1001/jama.289.1.80
  8. Kiewiet JJ, Leeuwenburgh MM, Bipat S, et al. A systematic review and meta-analysis of diagnostic performance of imaging in acute cholecystitis. Radiology 2012;264(3):708–720. DOI: 10.1148/radiol.12111561
  9. Anderson SW, Lucey BC, Varghese JC, et al. Accuracy of MDCT in the diagnosis of choledocholithiasis. AJR Am J Roentgenol 2006;187(1):174–180. DOI: 10.2214/AJR.05.0459
  10. Ziessman HA. Nuclear medicine hepatobiliary imaging. Clin Gastroenterol Hepatol 2010;8(2):111–116. DOI: 10.1016/j.cgh.2009.10.017
  11. Huffman JL, Schenker S. Acute acalculous cholecystitis: a review. Clin Gastroenterol Hepatol 2010;8(1):15–22. DOI: 10.1016/j.cgh.2009.08.034
  12. Adusumilli S, Siegelman ES. MR imaging of the gallbladder. Magn Reson Imaging Clin N Am 2002;10(1):165–184. DOI: 10.1016/s1064-9689(03)00055-2
  13. Håkansson K, Leander P, Ekberg O, et al. MR imaging in clinically suspected acute cholecystitis. A comparison with ultrasonography. Acta Radiol 2000;41(4):322–328. DOI: 10.1080/028418500127345587
  14. Yokoe M, Hata J, Takada T, et al. Tokyo guidelines 2018: diagnostic criteria and severity grading of acute cholecystitis (with videos). J Hepatobiliary Pancreat Sci 2018;25(1):41–54. DOI: 10.1002/jhbp.515
  15. Johansson M, Thune A, Blomqvist A, et al. Management of acute cholecystitis in the laparoscopic era: results of a prospective, randomized clinical trial. J Gastrointest Surg 2003;7(5):642–645. DOI: 10.1016/s1091-255x(03)00065-9
  16. Miura F, Takada T, Kawarada Y, et al. Flowcharts for the diagnosis and treatment of acute cholangitis and cholecystitis: Tokyo guidelines. J Hepatobiliary Pancreat Surg 2007;14(1):27–34. DOI: 10.1007/s00534-006-1153-x
  17. Radder RW. Ultrasonically guided percutaneous catheter drainage for gallbladder empyema. Diagn Imaging 1980;49(6):330–333.
  18. Antalek M Jr, Riaz A, Nemcek AA Jr. Gallbladder: role of interventional radiology. Semin Intervent Radiol 2021;38(3):330–339. DOI: 10.1055/s-0041-1731371
  19. Winbladh A, Gullstrand P, Svanvik J, et al. Systematic review of cholecystostomy as a treatment option in acute cholecystitis. HPB (Oxford) 2009;11(3):183–193. DOI: 10.1111/j.1477-2574.2009.00052.x
  20. Loozen CS, Van Santvoort HC, Van Duijvendijk P, et al. Laparoscopic cholecystectomy versus percutaneous catheter drainage for acute cholecystitis in high risk patients (CHOCOLATE): multicentre randomised clinical trial. BMJ 2018;363:k3965. DOI: 10.1136/bmj.k3965
  21. Kamarajah SK, Karri S, Bundred JR, et al. Perioperative outcomes after laparoscopic cholecystectomy in elderly patients: a systematic review and meta-analysis. Surg Endosc 2020;34(11):4727–4740. DOI: 10.1007/s00464-020-07805-z
  22. Nielsen LB, Harboe KM, Bardram L. Cholecystectomy for the elderly: no hesitation for otherwise healthy patients. Surg Endosc 2014;28(1):171–177. DOI: 10.1007/s00464-013-3144-8
  23. Chikamori F, Kuniyoshi N, Shibuya S, et al. Early scheduled laparoscopic cholecystectomy following percutaneous transhepatic gallbladder drainage for patients with acute cholecystitis. Surg Endosc 2002;16(12):1704–1707. DOI: 10.1007/s00464-002-9004-6
  24. El-Gendi A, El-Shafei M, Emara D. Emergency versus delayed cholecystectomy after percutaneous transhepatic gallbladder drainage in grade II acute cholecystitis patients. J Gastrointest Surg 2017;21(2):284–293. DOI: 10.1007/s11605-016-3304-y
  25. Huang SZ, Chen HQ, Liao WX, et al. Comparison of emergency cholecystectomy and delayed cholecystectomy after percutaneous transhepatic gallbladder drainage in patients with acute cholecystitis: a systematic review and meta-analysis. Updates Surg 2021;73(2):481–494. DOI: 10.1007/s13304-020-00894-4
  26. Hatjidakis AA, Karampekios S, Prassopoulos P, et al. Maturation of the tract after percutaneous cholecystostomy with regard to the access route. Cardiovasc Intervent Radiol 1998;21(1):36–40. DOI: 10.1007/s002709900208
  27. Chang YR, Ahn YJ, Jang JY, et al. Percutaneous cholecystostomy for acute cholecystitis in patients with high comorbidity and re-evaluation of treatment efficacy. Surgery 2014;155(4):615–622. DOI: 10.1016/j.surg.2013.12.026
  28. Sanjay P, Mittapalli D, Marioud A, et al. Clinical outcomes of a percutaneous cholecystostomy for acute cholecystitis: a multicentre analysis. HPB (Oxford) 2013;15(7):511–516. DOI: 10.1111/j.1477-2574.2012.00610.x
  29. Pang KW, Tan CH, Loh S, et al. Outcomes of percutaneous cholecystostomy for acute cholecystitis. World J Surg 2016;40(11):2735–2744. DOI: 10.1007/s00268-016-3585-z
  30. Stanek A, Dohan A, Barkun J, et al. Percutaneous cholecystostomy: a simple bridge to surgery or an alternative option for the management of acute cholecystitis? Am J Surg 2018;216(3):595–603. DOI: 10.1016/j.amjsurg.2018.01.027
  31. Yao P, Chang Z, Liu Z. Factors influencing failure to undergo interval cholecystectomy after percutaneous cholecystostomy among patients with acute cholecystitis: a retrospective study. BMC Gastroenterol 2021;21(1):410. DOI: 10.1186/s12876-021-01989-x
  32. Kim YH, Kim YJ, Shin TB. 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. DOI: 10.3348/kjr.2011.12.2.210
  33. Comin JM, Cade RJ, Little AF. Percutaneous cystic duct stent placement in the treatment of acute cholecystitis. J Med Imaging Radiat Oncol 2010;54(5):457–461. DOI: 10.1111/j.1754-9485.2010.02207.x
  34. Chen SY, Huang R, Kallini J, et al. Outcomes following percutaneous cholecystostomy tube placement for acalculous versus calculous cholecystitis. World J Surg 2022;46(8):1886–1895. DOI: 10.1007/s00268-022-06566-1
  35. Abbas SH, Ghazanfar MA, Gordon-Weeks AN, et al. Acalculous cholecystitis: is an elective interval cholecystectomy necessary. Dig Surg 2018;35(2):171–176. DOI: 10.1159/000477780
  36. Chung YH, Choi ER, Kim KM, et al. Can percutaneous cholecystostomy be a definitive management for acute acalculous cholecystitis? J Clin Gastroenterol 2012;46(3):216–219. DOI: 10.1097/MCG.0b013e3182274375
  37. Noh SY, Gwon DI, Ko GY, et al. Role of percutaneous cholecystostomy for acute acalculous cholecystitis: clinical outcomes of 271 patients. Eur Radiol 2018;28(4):1449–1455. DOI: 10.1007/s00330-017-5112-5
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