Outcomes of Percutaneous Transhepatic Gallbladder Drainage for Patients with Acute Cholecystitis: A 10-year Experience at Tertiary Referral Centre

Description

Introduction: The definitive treatment for acute cholecystitis (AC) is cholecystectomy. However, percutaneous transhepatic gallbladder drainage (PTHGD) is an alternative approach for critically ill and surgically unfit patients. This study aimed to assess the efficacy and outcomes of PTHGD over a 10-year period.
Methods: All patients with AC who underwent PTHGD at Riga East University Hospital between 2013 and 2023 were reviewed retrospectively for complications, and short- and long-term outcomes.
Results: A total of 449 patients, with a median age of 80 years (IQR 73-85), were included. According to the ASA-PS score, 89.5% of patients had ASA≥3. PTHGD was performed within 48 hours in 308 (68.6%) patients. Drainage tube-related complications occurred in 37 (8.2%) patients, with bile leakage and peritonitis in 13 (2.9%) patients requiring emergency cholecystectomy. The median drainage duration was 9 days (IQR 6-14), and the median hospital stay was 12 days (IQR 9-15). During follow-up, 44 (9.8%) patients were readmitted for biliary disease-related events, of whom 27 (61.4%) patients had recurrent AC. In the study cohort, 275 (61.2%) patients underwent PTHGD as their definitive treatment, while the remaining underwent cholecystectomy. Overall, 127 (72.9%) patients underwent cholecystectomy on the index admission. The overall mortality rate was 5.3% (n=24), with no deaths related to the drainage procedure. Table 1 summarizes patient characteristics and outcomes of PTHGD.
Conclusion: PTHGD provided a definitive treatment with a low level of complications and without lethal outcome due to the procedure for more than three-fifths of high-risk patients, which indicates the effectiveness and safety of PTHGD for these patients with AC.

Period	10 Jun 2025
Event title	16th Biennial Congress of the European-African Hepato-Pancreato-Biliary Association
Event type	Congress
Conference number	16
Location	Dublin, IrelandShow on map
Degree of Recognition	International