TTP5.14 Use of Percutaneous Cholecystostomy in Elderly and Patients with Multiple Co-morbidities

Aims To study the benefits of cholecystostomy in elderly and patients unsuitable for ‘Hot Gall Bladder’ surgery in a district general hospital. Methods Data was retrospectively collected from patients admitted to a District General Hospital with acute cholecystitis who underwent cholecystostomy between August 2021 and August 2024. Results A total of 34 patients were identified during the period. The cohort included 19 males and 15 females with a mean age of 69 years. There was an average of 2 days between the decision of cholecystostomy and drain insertion (with an outlier of 25 days). Total hospital admission lasted an average of 13.5 days, with 8.4 post cholecystostomy. 2 patients needed ITU support with reasons of admission including renal failure and septic shock. 53% (18/34) went on to have cholecystectomy post-discharge. 20.6% (7/34) needed readmission after cholecystostomy. Common reasons for readmission were pain at the drain site and symptoms returning post-removal. The mortality rate was 8.82% (3/34). Conclusion Percutaneous cholecystostomy is one of the alternative methods of managing patients with acute severe cholecystitis unsuitable for emergency cholecystectomy due to multiple co-morbidities and polypharmacy. Though our numbers are small, our study shows low mortality and readmission rates. When considering percutaneous cholecystostomy, early interventional radiology input is beneficial.