Percutaneous cholecystostomy in High-risk geriatric patients with acute cholecystitis

Abstract

Objective: To determine the results of high-risk geriatric patients treated with percutaneous cholecystostomy (PC) for acute cholecystitis (AC).

Study Design: Observational study.

Place and Duration of Study: Department of Interventional Radiology, Recep Tayyip Erdogan University Hospital, Rize, Turkey, from April 2015 to October 2020.

Methodology: Seventy-four patients, who underwent PC with a diagnosis of AC, were divided into three groups according to their ages: 65-74 years as group I, 75-84 years as group II, and >= 85 years as group III. Groups were compared in terms of American Society of Anesthesiologists (ASA) score, Charlson Comorbidity Index (CCI), technical success, clinical success, complications, need for cholecystectomy, duration of hospital stay, 30 and 90 days mortality, catheter removal time, and recurrent cholecystitis after catheter insertion.

Results: Technical success was 100% in all groups. Clinical success decreased with age. There was a positive correlation between the patients' ASA score and age (p <0.001). The duration of hospital stay increased with age (p = 0.049). ASA score was found to be an independent risk factor in predicting overall survival (HR: 4.748; 95% CI: 1.030-21.895; p = 0.046). The mean catheter removal time was the longest in group III, and there was a significant difference between the groups (p <0.001). A significant positive correlation was found between catheter removal time and CCI (p <0.001). There was no statistically significant difference between groups in terms of complications and recurrent cholecystitis.

Conclusion: PC can be considered as definitive treatment in advanced elderly patients and interval therapy in early old age.