Percutaneous Cholecystostomy for Gangrenous Cholecystitis: is It as Effective and Safe as for Simple (Non-gangrenous) Cholecystitis?

Sunday, March 30, 2025

3:45 PM – 3:54 PM CT

Location: Music City Center, 205 A

Presenting Author(s)

Ahmad M. Wady (he/him/his)

Medical Student
SUNY Upstate Medical University, United States

Author/Co-author(s)

Griffin Johnson, BA

Medical Student
SUNY Upstate Medical University, United States
Katsuhiro Kobayashi, MD

Associate professor
SUNY Upstate Medical University, United States

Purpose: Gangrenous cholecystitis (GC) is a severe form of acute cholecystitis (AC) associated with ischemic necrosis of the gallbladder wall. Percutaneous cholecystostomy (PC) is used for AC in p</span>atients with high surgical risk, however, the safety and efficacy of PC in the setting of GC remain unclear. This study's purpose was to compare the efficacy and safety of PC between GC and simple AC (non-GC).

Materials and Methods: A total of 248 PCs (152 male/96 female, median age: 69) performed from 2014 to 2023 were included in this single-institution study. Retrospective review of chart and imaging {1} identified 25 patients with GC and 223 patients with non-GC. The efficacy was evaluated by 1) 30-day mortality rate, 2) rate of a bail-out cholecystectomy (due to lack of clinical improvement following PC), 3) resolution of sepsis or abdominal pain within 48 hours, and 4) length of hospitalization after PC. Major complications according to the SIR Quality Standards statement {2} were also recorded. Chi-Square analysis was used for group comparisons.

Results: The 30-day mortality rate, rate of a bail-out cholecystectomy, and mean length of hospital stay were not significantly different between the groups (Table). While pain relief within 48 hours was not significantly different between the groups, resolution of sepsis within 48 hours was significantly less observed in patients with GC (Table). The incidence of major complications was significantly higher in the GC group (Table). Of note, sepsis following PC and gallbladder rupture were significantly more common in the GC group (Table).

Conclusion: PC for GC was as clinically effective as that for non-GC, however, major complications including gallbladder rupture or post-procedural sepsis were more common in patients with GC.