Retrospective Study
Copyright ©The Author(s) 2020. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Clin Cases. Mar 26, 2020; 8(6): 1033-1041
Published online Mar 26, 2020. doi: 10.12998/wjcc.v8.i6.1033
Clinical course of percutaneous cholecystostomies: A cross-sectional study
Sadettin Er, Hüseyin Berkem, Sabri Özden, Birkan Birben, Erdinç Çetinkaya, Mesut Tez, Bülent Cavit Yüksel
Sadettin Er, Hüseyin Berkem, Sabri Özden, Birkan Birben, Erdinç Çetinkaya, Mesut Tez, Bülent Cavit Yüksel, Department of Surgery, Ankara Numune Training and Research Hospital, Ankara 06100, Turkey
Author contributions: All authors helped perform the research; Er S, Özden S manuscript writing, performing procedures and data analysis; Er S, Tez M manuscript writing, drafting conception and design, performing experiments, and data analysis; Berkem H manuscript writing, drafting conception and design; Özden S, Birben B, Çetinkaya E manuscript writing; Tez M, Yüksel BC manuscript writing, drafting conception and design and critical revision of manuscript.
Institutional review board statement: This study was reviewed and approved by the Ethics Committee of Ankara Numune Training and Research Hospital (Approval number: E-1720).
Informed consent statement: Informed consent of the patients was not required because the analysis used anonymous clinical data obtained from each patient that agreed to the treatment by written consent.
Conflict-of-interest statement: The authors declare no conflict of interest related to this article.
Data sharing statement: No additional data are available.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Corresponding author: Mesut Tez, MD, Associate Professor, Lecturer, Surgical Oncologist, Department of Surgery, Ankara Numune Training and Research Hospital, Sakarya Mh. Ulucanlar Cd. No. 89 Altındağ/ANKARA, Ankara 06100, Turkey. mesuttez@yahoo.com
Received: December 19, 2019
Peer-review started: December 19, 2019
First decision: January 12, 2020
Revised: March 11, 2020
Accepted: March 19, 2020
Article in press: March 19, 2020
Published online: March 26, 2020
Processing time: 97 Days and 18.1 Hours
ARTICLE HIGHLIGHTS
Research background

In this retrospective study, the clinical course of percutaneous cholecystostomy (PC) was evaluated in 82 patients who had comorbidities and had high mortality risk after surgery. The benefits and success rate of PC were revealed in the selected patient population.

Research motivation

In the literature, the significance of PC was not identified in patients who had Grade 2 and 3 acute cholecystitis (AC) (Tokyo Guidelines 2018) and comorbidities. This study confirms that PC is a safe and adequate treatment option.

Research objectives

In this study, we emphasized that PC alone is an adequate treatment in patients with AC based on our finding that only nine of the 66 patients discharged from the hospital required cholecystectomy. In patients that died, mortality usually occurred for non-biliary reasons during the follow-up without recurrent episodes. PC without general anesthesia may be an adequate treatment option in these patients.

Research methods

The study was planned retrospectively. In the follow-up of patients undergoing PC, the causes of death and duration of survival after the procedure were obtained from the electronic medical records.

Research results

Our findings support that PC is an effective alternative method that can be safely applied to patients with a high comorbidity load, and it can regress clinical symptoms in this patient group. During the retrospective acquisition of the study data by screening the electronic medical records, the number of patients was reduced due to the exclusion of those with incomplete records. Therefore, a future prospective study can be planned to obtain the records of all patients in detail to further emphasize the individual adequacy of PC.

Research conclusions

Except for nine cases, PC alone was an adequate and safe treatment alternative in all the remaining evaluated patients with AC. PC is an alternative effective treatment option in AC cases with a high comorbidity load. This study revealed that in the long-term follow-up of patients who had undergone PC and had been discharged, mortality occurred mostly due to non-biliary causes, except for a limited number of cases with a history of episodes, confirming that the procedure was successful, which is a finding that contributes to the literature. PC can be safely used as an alternative treatment in patients with high risk of surgery and provides adequate clinical improvement. We consider that PC presents as a good alternative with a high success rate in patients with AC who have a comorbidity load, those at high risk of anesthesia-related complications, and those that do not agree to undergo surgery after clinical recovery is achieved.

Research perspectives

Despite performing PC in the patient population with AC and high comorbidity, approximately 20% of the patients developed mortality. However, the considerable success rate of the procedure presents it as a good treatment option.