AI Summary & Key Takeaways
AI InsightAims: Percutaneous cholecystostomy (PC) is recommended for high-risk patients with acute cholecystitis who are unsuitable for early cholecystectomy.
📌 3 Key Takeaways
Abstract
Aims: Percutaneous cholecystostomy (PC) is recommended for high-risk patients with acute cholecystitis who are unsuitable for early cholecystectomy. However, clinical outcomes and mortality remain closely linked to patient frailty and comorbidity burden. This study aimed to evaluate short-term clinical outcomes and 30-day mortality in high-risk patients undergoing PC. Methods: This retrospective cohort study included consecutive adult patients who underwent PC for acute cholecystitis at a tertiary care center between 2021 and 2025. Demographic characteristics, comorbidities, Charlson Comorbidity Index (CCI), American Society of Anesthesiologists (ASA) physical status, Tokyo severity grade, clinical presentation, and hospital outcomes were analyzed. The primary endpoint was 30-day mortality. Secondary outcomes included clinical improvement, intensive care unit (ICU) requirement, length of hospital stay, and interval cholecystectomy rate. Results: A total of 55 patients were included (median age 78 years; 53% male). Most patients had Tokyo grade III disease (80%) and high surgical risk (ASA III-IV in 98%). The median CCI was 5 (1-11). Clinical improvement after PC was achieved in 82% of patients. ICU admission was required in 16%, and the median hospital stay was 7 days (4-12). Interval cholecystectomy was performed in 24% of patients, predominantly via a laparoscopic approach (85%). The 30-day mortality rate was 13%. Conclusion: Percutaneous cholecystostomy provides effective acute-phase control in elderly, high-risk patients with acute cholecystitis. However, early mortality remains substantial in this high-risk population, and outcomes should be interpreted within the context of advanced comorbidity burden and severe clinical status. Careful patient selection and structured follow-up strategies are essential to optimize outcomes.