Percutaneous cholecystostomy: The radiologist's role in treating acute cholecystitis

• Published in: Clinical radiology Vol. 68; no. 7; pp. 654 - 660
• Main Authors: Little, M.W, Briggs, J.H, Tapping, C.R, Bratby, M.J, Anthony, S, Phillips-Hughes, J, Uberoi, R
• Format: Journal Article
• Language: English
• Published: England Elsevier Ltd 01.07.2013
• Subjects: Analgesics - therapeutic use; Catheterization - methods; Cholecystitis, Acute - surgery; Cholecystostomy - methods; Conscious Sedation; Contraindications; Critical Care; Decompression, Surgical - methods; Female; Humans; Kidney Failure, Chronic - complications; Postoperative Care - methods; Pregnancy; Pregnancy Complications - surgery; Radiography, Interventional; Radiology; Specimen Handling; Tomography, X-Ray Computed; Treatment Outcome; Ultrasonography, Interventional
• ISSN: 0009-9260; 1365-229X
• DOI: 10.1016/j.crad.2013.01.017

Acute cholecystitis is a common condition, with laparoscopic cholecystectomy considered the gold-standard for surgical management. However, surgical options are often unfavourable in patients who are very unwell, or have numerous medical co-morbidities, in which the mortality rates are significant. Percutaneous cholecystostomy (PC) is an image-guided intervention, used to decompress the gallbladder, reducing patient's symptoms and the systemic inflammatory response. PC has been shown to be beneficial in high-risk patient groups, predominantly as a bridging therapy; allowing safer elective cholecystectomy once the patient has recovered from the acute illness; or, in the minority, as a definitive treatment in patients deemed unfit for surgery. This review aims to develop a broader understanding of PC, discussing its specific indications, patient management, technical factors, imaging guidance, and outcomes following the procedure.