534 - Analysis of Intervention Sequences Following Percutaneous Cholecystostomy for Acute Cholecystitis

Monday, April 13, 2026

12:10 PM - 1:10 PM ET

Poster Presenter(s)

SS

Sahil Sardesai, BS

Medical Student
Penn State College of Medicine, United States

Author/Co-author(s)

KY

Kevin Yiu, DO

Fellow, Interventional Radiology
Memorial Sloan Kettering, United States
NP

Nirnimesh Pandey, MD

Assistant Professor, Cardiovascular & Interventional Radiology
Penn State Health Milton S. Hershey Medical Center, United States
BS

Benjamin Shin, MD

Associate Professor, Radiology
Pennsylvania State College of Medicine, United States

Purpose: To assess frequency, time to treatment, and mortality for different intervention pathways following initial percutaneous cholecystostomy for acute cholecystitis.

Materials and Methods: Using TriNetX US Collaborative Network data (2010–2025), we identified adult patients with no prior history of hepatopancreatobiliary malignancy who underwent percutaneous cholecystostomy (PC) for treatment of acute cholecystitis. Interventions analyzed included biliary drainage catheter exchange, biliary drainage catheter removal, laparoscopic cholecystectomy (LC), and open cholecystectomy (OC). Inclusion criteria, exclusion criteria, and interventions were determined by ICD-10 and CPT billing codes. Treatment pathway analyses were entirely completed within the TriNetX software platform, and workflow evaluation was conducted within the 365 days following initial PC placement. Kaplan-Meier analysis assessed mortality rate following intervention.

Results: 14,964 patients met inclusion criteria for analysis. Mean age at PC placement was 65.6, and the cohort was 71.4% White, 13.4% Black, and 62.7% Male. 15.3% of patients were deceased before an analyzed intervention. Of remaining patients, 46.2% received follow-up intervention at a Healthcare Organization (HCO) within TriNetX, allowing for intervention sequence analysis. Within 365 days following initial PC, 46.7% of patients underwent continued exchange procedures without gallbladder excision, 29.2% underwent LC, 15.8% of patients underwent OC, and 4.3% of patients underwent cholecystostomy removal without surgical intervention. 18.1% of patients who underwent LC and 19.9% of patients who underwent OC received at least one exchange before resection. Of patients who progressed to LC or OC without any drainage catheter exchange, mean duration to surgery was 59.0 and 61.2 days, respectively. For patients who received LC or OC following an exchange, mean duration to surgery was 107.2 and 127.9 days, respectively.

Conclusion: The variability in post-PC management underscores the need for standardized treatment pathways and better patient counseling regarding likely trajectories and timelines. Future work should focus on establishing consensus guidelines for downstream management.