Short-term efficacy of early percutaneous cholecystostomy for pancreatitis and factors associated with recurrence and mortality

doi:10.3748/wjg.v31.i6.101163

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Feb 14, 2025 (publication date) through Feb 21, 2025

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World Journal of Gastroenterology

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1007-9327

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Baishideng Publishing Group Inc, 7041 Koll Center Parkway, Suite 160, Pleasanton, CA 94566, USA

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World J Gastroenterol. Feb 14, 2025; 31(6): 101163
Published online Feb 14, 2025. doi: 10.3748/wjg.v31.i6.101163

Table 1 Pretreatment baseline data of patients in both groups (measured data)

Variable	PC group (n = 54)	Conservative group (n = 29)	t/z value	P value
Age (years)	62.7 ± 20.63	55.55 ± 15.92	1.624	0.108
BMI	25.31 ± 3.34	24.62 ± 2.47	0.983	0.329
Hospitalization (days)	17.28 ± 9.72	15.9 ± 4.36	0.726	0.47
Temperature (°C)	37.5 (36.8-38.18)	37.8 (37.3-38.5)	-0.513	0.130
WBC (× 10⁹/L)	13.6 (10.87-16.62)	12.6 (8.95-16.73)	-0.817	0.414
NEU (%)	88.2 (82.8-90.9)	85.1 (78.6-88.95)	-1.662	0.097
ALT (U/L)	49 (24.68-100.45)	35.9 (28.5-48.9)	-1.027	0.305
GGT (U/L)	106.5 (51.5-238)	71 (52.5-126.5)	-1.141	0.254
TBIL (μmol/L)	29.35 (17.57-54)	22.2 (17.4-29.5)	-1.944	0.052
DBIL (μmol/L)	2.75 (0-12.95)	0 (0-4.65)	-1.562	0.118
IBIL (μmol/L)	13.9 (8.58-27)	11.7 (8.7-13.4)	-1.829	0.067
AMS (U/L)	394.5 (151.25-1060)	211 (101.5-650)	-1.705	0.088
CTSI	3 (3-5)	3 (3-3)	-0.282	0.778

PC: Percutaneous cholecystostomy; BMI: Body mass index; WBC: White blood cell; NEU: Neutrophil; ALT: Alanine aminotransferase; GGT: Gamma-glutamyl transferase; TBIL: Total bilirubin; DBIL: Direct bilirubin; IBIL: Indirect bilirubin; AMS: Amylase; CTSI: Computed tomography severity index.

Table 2 Pretreatment baseline data for both groups, n (%)

Variable	PC group (n = 54)	Conservative group (n = 29)	χ² value	P value
Sex			0.774	0.379
Male	30 (55.6)	19 (65.5)
Female	24 (44.4)	10 (34.5)
Charlson comorbidities
Congestive heart failure	2 (3.7)	0	-	0.540
Diabetes mellitus (no comorbidities)	14 (25.9)	8 (27.6)	0.027	0.870
Solid tumors (no metastases)	3 (5.6)	0	-	0.548
Cerebrovascular disease	11 (20.4)	2 (6.9)	1.673	0.196
Use of antimicrobials
Cephalosporins	19 (35.2)	9 (31)	0.145	0.703
Nitroimidazoles	30 (55.6)	13 (44.8)	0.870	0.351
Growth inhibitors	34 (63)	17 (58.6)	0.150	0.698
Proton pump inhibitors	25 (46.3)	12 (41.4)	0.185	0.667
Combinations	40 (74.1)	22 (75.9)	0.032	0.858

PC: Percutaneous cholecystostomy.

Table 3 Comparison of body temperature and related laboratory indicators before and after percutaneous cholecystostomy treatment

Variable	Pre-treatment	Post-treatment	Z value	P value
Temperature (°C)	37.5 (36.8-38.18)	37 (36.95-37.63)	-2.447	0.014^a
WBC (× 10⁹/L)	13.6 (10.87-16.62)	10.65 (7.12-13.86)	-3.035	0.002^a
NEU (%)	88.2 (82.8-90.9)	80.15 (73.2-85.93)	-5.132	< 0.001^a
ALT (U/L)	49 (24.68-100.45)	34.7 (23-72.05)	-3.306	< 0.001^a
GGT (U/L)	106.5 (51.5-238)	98.5 (48.75-170)	-2.603	0.009^a
TBIL (μmol/L)	29.35 (17.57-54)	21.6 (13-34.68)	-4.064	< 0.001^a
DBIL (μmol/L)	2.75 (0-12.95)	2.75 (0-7.33)	-1.873	0.061
IBIL (μmol/L)	13.9 (8.58-27)	10.1 (7.63-16.65)	-3.692	< 0.001^a
AMS (U/L)	394.5 (151.25-1060)	63 (41.75-89)	-6.169	< 0.001^a

^aP < 0.05.

WBC: White blood cell; NEU: Neutrophil; ALT: Alanine aminotransferase; GGT: Gamma-glutamyl transferase; TBIL: Total bilirubin; DBIL: Direct bilirubin; IBIL: Indirect bilirubin; AMS: Amylase.

Table 4 Comparison of body temperature and related laboratory indexes after treatment in two groups of patients

Variable	PC group (n = 54)	Conservative group (n = 29)	Z value	P value
Temperature (°C)	37 (36.95-37.63)	37.7 (37.35-38.05)	-3.135	0.002^a
WBC (× 10⁹/L)	10.65 (7.12-13.86)	13.42 (9.41-16.17)	-1.987	0.047^a
NEU (%)	80.15 (73.2-85.93)	79.5 (68.95-85.45)	-0.812	0.417
ALT (U/L)	34.7 (23-72.05)	52 (39.55-70.15)	-2.292	0.022^a
GGT (U/L)	98.5 (48.75-170)	132 (102-190.5)	-2.230	0.026^a
TBIL (μmol/L)	21.6 (13-34.68)	27.9 (21.6-32.65)	-1.968	0.049^a
DBIL (μmol/L)	2.75 (0-7.33)	12.9 (0-16.85)	-2.271	0.023^a
IBIL (μmol/L)	10.1 (7.63-16.65)	12.9 (8.6-17.25)	-1.012	0.311
AMS (U/L)	63 (41.75-89)	64 (43-90)	-0.076	0.939

^aP < 0.05.

PC: Percutaneous cholecystostomy; WBC: White blood cell; NEU: Neutrophil; ALT: Alanine aminotransferase; GGT: Gamma-glutamyl transferase; TBIL: Total bilirubin; DBIL: Direct bilirubin; IBIL: Indirect bilirubin; AMS: Amylase.

Table 5 Pre-percutaneous cholecystostomy comparison between the nonrecurrent and recurrent groups, n (%)

Variables	Nonrecurrent group (n = 37)	Recurrent group (n = 10)	Single factor analysis	Multi-factor analysis
Variables	Nonrecurrent group (n = 37)	Recurrent group (n = 10)	P value	P value [OR (95%CI)]
Age (years)	66.14 ± 17.1	42.5 ± 21	< 0.001^a	0.047 [0.937 (0.878-0.999)]
Sex			0.897
Male	19 (51.4)	6 (60)
Female	18 (48.6)	4 (40)
BMI	25.03 ± 2.99	26.6 ± 3.5	0.164
RAC classification			0.897
Moderately severe	19 (51.4)	6 (60)
Severe	18 (48.6)	4 (40)
Bile duct stone type			0.379
Positive stones	27 (73)	4 (40)
Negative stones	17 (45.9)	6 (60)
Day of hospitalization (days)	15.7 ± 10.31	19.9 ± 6.82	0.232
Fever (temperature ≥ 37.3 °C)	20 (54.1)	4 (40)	0.117
WBC (× 10⁹/L)	13.09 (10.85-16.56)	15.54 (10.01-17.08)	0.697
NEU (%)	87.9 (82.8-91.15)	86.35 (79.25-89.23)	0.176
ALT (U/L)	53.3 (23.85-129.45)	29 (21-105.83)	0.311
GGT (U/L)	108 (51-280)	97 (46.25-174.25)	0.659
TBIL (μmol/L)	25.5 (15.85-68.8)	22.9 (17.45-40.85)	0.467
AMS (U/L)	398 (156.5-983)	420 (129.5-1327.25)	0.938
Gallbladder width (cm)	3.6 (3.1-4)	3.45 (2.98-3.93)	0.474
CTSI	3 (1.5-3.5)	4 (3-5)	0.043^a	0.209 [1.596 (0.770-3.311)]
CCI	4 (3-5)	2.5 (2-4)	0.023^a	0.925 [1.036 (0.491-2.188)]
Congestive heart failure	2 (5.4)	0	1
Diabetes mellitus (no comorbidities)	8 (21.6)	5 (50)	0.167
Solid tumors (no metastases)	2 (4.3)	0	1
Cerebrovascular disease	7 (18.9)	0	0.322
History of pancreatitis	7 (18.9)	4 (40)	0.329
Hypertension	18 (48.6)	4 (40)	0.897

^aP < 0.05.

PC: Percutaneous cholecystostomy; BMI: Body mass index; RAC: Revised Atlanta classification; WBC: White blood cell; NEU: Neutrophil; ALT: Alanine aminotransferase; GGT: Gamma-glutamyl transferase; TBIL: Total bilirubin; DBIL: Direct bilirubin; AMS: Amylase; CTSI: Computed tomography severity index; CCI: Charlson Comorbidity Index; OR: Odds ratio; CI: Confidence interval.

Table 6 Pre-percutaneous cholecystostomy comparisons between the nonfatal and fatal groups, n (%)

Variables	Nonfatal group (n = 47)	Fatal group (n = 7)	Single factor analysis	Multi-factor analysis
Variables	Nonfatal group (n = 47)	Fatal group (n = 7)	P value	P value [OR (95%CI)]
Age (years)	61.11 ± 20.27	73.43 ± 21.31	0.142
Sex			0.443
Male	25 (53.2)	5 (71.4)
Female	22 (46.8)	2 (28.6)
BMI	25.37 ± 3.13	25.13 ± 4.68	0.861
RAC classification			0.102
Moderately severe	25 (53.2)	1 (14.3)
Severe	22 (46.8)	6 (85.7)
Days of hospitalization (days)	16.6 ± 9.76	21.86 ± 8.69	0.184
Fever (≥ 37.3 °C)	24 (51.1)	6 (85.7)	0.117
WBC (× 10⁹/L)	13.25 (10.88-16.52)	16.28 (9.77-18.58)	0.495
NEU (%)	87.2 (82.8-90.7)	90.3 (88.3-91.6)	0.116
ALT (U/L)	36 (23.7-115)	59 (48-81)	0.212
GGT (U/L)	108 (52-265)	105 (47-162)	0.757
TBIL (μmol/L)	25.5 (16.7-54.3)	34.1 (29.5-36.2)	0.374
DBIL (μmol/L)	3 (0-14)	2 (0-8.5)	0.799
IBIL (μmol/L)	14.3 (8.6-30.3)	13.1 (4.2-23.5)	0.361
AMS (U/L)	398 (152-1051)	173 (148-1087)	0.643
Gallbladder width (cm)	3.6 (3-4.1)	3.4 (2.7-4.9)	0.918
CTSI	3 (1-5)	3 (1-5)	0.821
CCI	4 (2-5)	6 (5-8)	0.001^a	0.021 [2.397 (1.139-5.047)]
Congestive heart failure	2 (4.3)	0	1
Diabetes mellitus (no comorbidities)	13 (27.7)	1 (14.3)	0.771
Solid tumors (no metastases)	2 (4.3)	1 (14.3)	0.346
Cerebrovascular disease	7 (14.9)	4 (57.1)	0.037^a	0.659 [1.631 (0.186-14.336)]
History of pancreatitis	11 (23.4)	1 (14.3)	0.957
Hypertension	22 (46.8)	3 (42.9)	1

^aP < 0.05.

PC: Percutaneous cholecystostomy; BMI: Body mass index; RAC: Revised Atlanta classification; WBC: White blood cell; NEU: Neutrophil; ALT: Alanine aminotransferase; GGT: Gamma-glutamyl transferase; TBIL: Total bilirubin; DBIL: Direct bilirubin; IBIL: Indirect bilirubin; AMS: Amylase; CTSI: Computed tomography severity index; CCI: Charlson Comorbidity Index; OR: Odds ratio; CI: Confidence interval.

Citation: Yan X, Xie F, Zhao XD, Li L, Meng JX. Short-term efficacy of early percutaneous cholecystostomy for pancreatitis and factors associated with recurrence and mortality. World J Gastroenterol 2025; 31(6): 101163
URL: https://www.wjgnet.com/1007-9327/full/v31/i6/101163.htm
DOI: https://dx.doi.org/10.3748/wjg.v31.i6.101163