Comparative analysis of percutaneous gallbladder aspiration vs percutaneous cholecystostomy in acute calculous cholecystitis

Abstract

Background & objectives: Acute cholecystitis, a prevalent cause of acute abdomen pain, is primarily induced by gallstone obstruction, leading to significant inflammation and potentially severe complications. This study focuses on comparing the effectiveness and complication rates of percutaneous gallbladder aspiration versus percutaneous cholecystostomy in managing severe acute calculous cholecystitis, aiming to enhance patient care by optimizing treatment strategies.

Methodology: In this study we evaluate the efficacy and safety of percutaneous gallbladder aspiration (PGA) versus percutaneous cholecystostomy (PC) in 35 patients with acute calculous cholecystitis. Utilizing ultrasound-guided procedures, patients were either subjected to PGA, using an 18-19-gauge spinal needle for gallbladder drainage, or where an 8-12 French pigtail catheter facilitated gallbladder decompression.

Results: In this study of 35 patients with acute calculous cholecystitis, 25 underwent percutaneous gallbladder aspiration and 10 underwent percutaneous cholecystostomy. Post-procedure, 88% of the aspiration group and 80% of the cholecystostomy group reported no pain, with the majority in both groups showing a positive total response score. Analgesic demand post-procedure was low, with 76% of the aspiration group and 70% of the cholecystostomy group requiring no analgesia. Complication rates were 12% for the aspiration group and 20% for the cholecystostomy group, with overall success rates of 92% and 90%, respectively, indicating no significant difference in outcomes between the two methods.

Conclusions:  This study's comparative analysis of PGA and PC offers essential insights into managing acute calculous cholecystitis in high-risk surgical candidates. With both procedures demonstrating high success rates and minimal complications, they emerge as viable alternative treatments. Future studies should focus on evaluating their long-term efficacy and optimizing patient selection criteria to enhance outcomes.

Abbreviations: PC - percutaneous cholecystostomy; PGA - percutaneous gallbladder aspiration; HIDA - hepatoimino diacetic acid scan;

Keywords: percutaneous gallbladder aspiration, percutaneous cholecystostomy, acute cholecystitis, non-surgical, radiology

Citation: Alhussein MA, Mahdi MA. Comparative analysis of percutaneous gallbladder aspiration vs percutaneous cholecystostomy in acute calculous cholecystitis. Anaesth. pain intensive care 2024;28(6):1077-1083; DOI:10.35975/apic.v28i6.2607

Received: December 21, 2021; Reviewed: February 11, 2023; Accepted: February 12, 2023