A retrospective study of percutaneous cholecystostomy outcomes in a community hospital

Jonathan Meija; Melissa Meghpara; Omar Wain; Tyler Liguori; Sutasinee Nithisoontorn; Robert Solomon; Martine A. Louis; Nageswara Mandava

doi:10.18203/2349-2902.isj20240163

Authors

Jonathan Meija Department of Surgery, Flushing Hospital Medical Center, Flushing, New York, USA
Melissa Meghpara Department of Surgery, Flushing Hospital Medical Center, Flushing, New York, USA
Omar Wain Department of Surgery, Flushing Hospital Medical Center, Flushing, New York, USA
Tyler Liguori New York Institute of Technology, New York, USA
Sutasinee Nithisoontorn Flushing Hospital Medical Center, Flushing, New York, USA
Robert Solomon Department of Surgery, Flushing Hospital Medical Center, Flushing, New York, USA
Martine A. Louis Department of Surgery, Flushing Hospital Medical Center, Flushing, New York, USA
Nageswara Mandava Department of Surgery, Flushing Hospital Medical Center, Flushing, New York, USA

DOI:

https://doi.org/10.18203/2349-2902.isj20240163

Keywords:

AC, PCT, Post-operative outcomes, Community hospital, Critically ill patients

Abstract

Background: The gold standard of treatment for acute cholecystitis (AC) typically involves operative intervention, specifically cholecystectomy. However, initial nonoperative management rather than immediate cholecystectomy has been recommended for critically ill patients. Non-operative interventions, such as percutaneous cholecystostomy (PCT), may represent viable alternatives. The current study examines risk factors associated with worse outcomes of AC among critically ill patients with AC treated conservatively.

Methods: This retrospective study examined data from 121 patients with AC presenting to a NYC-area community hospital. Differences in demographic, clinical, and procedural characteristics were examined in relation to post-operative outcomes, including mortality.

Results: The sample tended to be older, with 31% of patients identifying as non-Hispanic white. One-third of the sample were admitted to the ICU. The median time between admission placement and PCT was 2 days, the median time PCT was left in place was 42 days. The overall 90-day mortality rate was 21% and 33% among ICU patients. Patients identifying as non-Hispanic white and those with more severe clinical presentation were at higher risk for mortality within 90 days. Admission to intensive care units (ICU) was significantly associated with 90-day mortality.

Conclusions: The results of the current study provide a snapshot into the profiles of patients at-risk for negative outcomes following PCT placement. Sociodemographic risk factors and clinical severity were associated with increased risk of mortality among patients seen at a diverse, community hospital. These findings support the use of risk-stratified decision making regarding non-operative treatments of AC.

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