|ECR 2019 / C-1666|
|Cholecystectomy or percutaneous cholecystostomy as treatment for acute acalculous cholecystitis: 12 years of experience|
In the descriptive analysis we obtained these results:
- 20 patients were treated with antibiotics, 11 underwent cholecystostomy and 53 cholecystectomy. Due to the small number of cholecystostomies and in order to increase the sample in the conservative treatment group, we decided to combine both the antibiotic and cholecystostomy groups.
- Five patients died
- Only two patients in the conservative treatment group underwent elective cholecystectomy
- Generally, elderly and critically ill patients, with high surgical risk, were treated conservatively, in fact (click) statistically significant differences were achieved between cholecystostomy and surgery groups.
- There were no complications in the patients treated conservatively.
- There was no need for surgery due to failure of conservative treatment
- Mortality was higher in the conservative treatment group, five patients, which can be explained by the greater initial clinical severity (Fig. 10).
Here it is important to note that only 1 of these patients underwent cholecystostomy so there were no significant differences regarding the mortality between cholecystostomy and cholecystectomy (Fig. 11).
In order to homogenize the sample and make the two groups similar, we matched the sample according to sex, age, charlson index and ASA and we obtained these results, similar to the previous one:
- There were no complications or need of urgent surgery in the conservative group, as previously mentioned.
- There were no significant differences regarding mortality between conservative and cholecystectomy groups.
- Only 2 patients of the conservative group underwent elective cholecystectomy, of whom only 1 had undergone cholecystostomy.
Our study has its limitations, for example, the sample size is small with 84 patients, of which only 11 underwent cholecystostomy, since before 2010 the surgeons did not request them systematically. Another limitation is that it is a retrospective study and the external validity is is limited by the presence of a radiologist on call who performs cholecystostomies.
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