Outcomes of Percutaneous Cholecystostomy in the Presence of Ascites

Purpose: To evaluate whether the presence of ascites increases complications following placement of percutaneous cholecystostomy tubes (PCTs). Materials and Methods: Retrospective review of all transhepatic PCTs placed between January 2005 and June 2014 was performed: 255 patients were included (Median age of 65 y; range, 20-95 y). Of these patients, 97 had ascites and 158 had no ascites or only pelvic fluid. In all, 115 patients had calculous cholecystitis (45%), 127 had acalculous cholecystitis (50%), and 13 had common bile duct obstruction (5%). The primary outcome of interest was all complications, including bile peritonitis, pericatheter leakage requiring PCT change, pericholecystic abscess formation, drain dislodgment, or death from biliary sepsis within 14 days of initial PCT insertion. Results: The overall complication rate was 11% among patients with ascites (n = 11), compared with 10% in those without (n = 16; P = .834). No difference was found between the two groups in any one complication. The overall outcome of PCT drainage differed between groups, with significantly shorter survival times in patients with ascites. Patients with ascites underwent cholecystectomy less often than patients without ascites (21% vs 39%; P = .002), Likewise, patients with ascites were more likely than those without ascites to die with the PCT in place (49% vs 25%; P = .001). Conclusions: Frequencies of complications following PCT insertion were similar in patients with and without ascites. Additionally, the overall complication rate was low and not significantly different between the two groups. These observations support the use of PCT placement in patients with ascites.