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Background <p>Critically ill patients frequently develop acute acalculous cholecystitis (AAC), particularly those requiring prolonged mechanical ventilation, ECMO, or CRRT. Percutaneous cholecystostomy is a minimally invasive alternative to cholecystectomy, yet transportation to the angiography suite may not be feasible in unstable ICU patients. This study aimed to compare the efficacy and outcome of bedside percutaneous cholecystostomy with the conventional technique performed in the angiography suite.</p> Methods <p>We retrospectively reviewed 70 ICU patients who underwent percutaneous cholecystostomy between January 2019 and December 2023 at a tertiary referral center. Patients were divided into two groups based on procedure setting: bedside trocar group (<i>n</i> = 26) and angiography suite group (<i>n</i> = 44). Baseline characteristics, SOFA scores, procedural outcomes, and complications were compared between the groups.</p> Results <p>The bedside group had higher rates of ECMO use (50% vs. 6.8%, <i>p</i> &lt; 0.001), inotrope support (76.9% vs. 52.3%, <i>p</i> = 0.041), and NO ventilation (30.8% vs. 6.8%, <i>p</i> = 0.008). Despite significantly higher pre-procedural SOFA scores (12.85 ± 2.59 vs. 9.77 ± 3.38, <i>p</i> &lt; 0.001), there were no significant differences in complication rates (42.3% vs. 27.3%, <i>p</i> = 0.196), catheter dislodgement, or in-hospital mortality (53.8% vs. 50.0%, <i>p</i> = 0.756) between groups. Catheter dislodgement was the most common complication and was not significantly associated with the technique used.</p> Conclusion <p>Bedside percutaneous cholecystostomy is a viable alternative for critically ill patients who are unable to be moved. This method provides effective biliary decompression even in patients with high disease severity who require multi-organ support.</p>

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The efficacy of bedside percutaneous cholecystostomy in critically ill patients: comparison with cholecystostomy performed in angiography suite

  • 期刊论文

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  • 发表日期：

    2025年10月7日

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  • Joo Yeon Jang,
  • Tae Un Kim,
  • Hwa Seong Ryu,
  • Yun Seong Kim,
  • Ryuk Jun Kwon,
  • Taehwa Kim

摘要

Background

Critically ill patients frequently develop acute acalculous cholecystitis (AAC), particularly those requiring prolonged mechanical ventilation, ECMO, or CRRT. Percutaneous cholecystostomy is a minimally invasive alternative to cholecystectomy, yet transportation to the angiography suite may not be feasible in unstable ICU patients. This study aimed to compare the efficacy and outcome of bedside percutaneous cholecystostomy with the conventional technique performed in the angiography suite.

Methods

We retrospectively reviewed 70 ICU patients who underwent percutaneous cholecystostomy between January 2019 and December 2023 at a tertiary referral center. Patients were divided into two groups based on procedure setting: bedside trocar group (n = 26) and angiography suite group (n = 44). Baseline characteristics, SOFA scores, procedural outcomes, and complications were compared between the groups.

Results

The bedside group had higher rates of ECMO use (50% vs. 6.8%, p < 0.001), inotrope support (76.9% vs. 52.3%, p = 0.041), and NO ventilation (30.8% vs. 6.8%, p = 0.008). Despite significantly higher pre-procedural SOFA scores (12.85 ± 2.59 vs. 9.77 ± 3.38, p < 0.001), there were no significant differences in complication rates (42.3% vs. 27.3%, p = 0.196), catheter dislodgement, or in-hospital mortality (53.8% vs. 50.0%, p = 0.756) between groups. Catheter dislodgement was the most common complication and was not significantly associated with the technique used.

Conclusion

Bedside percutaneous cholecystostomy is a viable alternative for critically ill patients who are unable to be moved. This method provides effective biliary decompression even in patients with high disease severity who require multi-organ support.