Role of Percutaneous Cholecystostomy in the Treatment of Grade-2 Acute Cholecystitis

Aim: Acute cholecystitis (AC) is one of the most common causes of emergency abdominal pain admissions. Its treatment is laparoscopic cholecystectomy. However, the disease's severity, duration, and the patient's general condition may necessitate effective alternative methods such as percutaneous cholecystostomy. This study aimed to analyze the place and importance of percutaneous cholecystostomy in the treatment of AC. Methods: The records of 122 patients who were interned with an AC diagnosis between January 2018 and July 2021 were retrospectively scanned. The demographic data of the patients, Tokyo grades, laboratory values, imaging findings, and treatments were comparatively analyzed. The patients determined as grade 3 AC were excluded from the study. The data of the patients with grade 1 and grade 2 AC were comparatively analyzed. Results: Fifty-four of 122 patients were grade 1; 66 of them were diagnosed as grade 2, and 2 of them were grade 3 AC. While 60 patients received only antibiotic treatment, 31 underwent percutaneous cholecystostomy, of whom 22 of them were from the grade 2 group. White blood cell, C-reactive protein, alanine transaminase, aspartate transaminase, Gamma-glutamyltransferase levels of grade 2 patients were statistically significantly higher than grade 1 patients (p<0.001; p<0.001; p=0.029; p=0.031; p=0.043). There were no significant differences between the groups in the values of alkaline phosphatase, bilirubin, time from admission to surgery, and followup time (p=0.077, p=0.908, p=0.119, and p=0.127, respectively). Age, mean fever duration, and chronic lung disease rates of grade 2 patients were statistically significantly higher than those of grade 1 patients (p<0.001, p<0.001, and p=0.002, respectively). Conclusion: Percutaneous cholecystostomy is an effective and the least invasive method for treating grade 2 AC.