Emergency cholecystectomy vs. percutaneous cholecystostomy for acute cholecystitis in high-risk patients: a comparison of mortality and clinical outcomes

Purpose: The aim of this study was to compare emergency cholecystectomy (EC) and percutaneous cholecystectomy (PC) in high-risk acute cholecystitis patients in respect of mortality and other clinical characteristics. Material and Methods: A retrospective examination was made of patients graded as ASA/PS≥3 who underwent EC or PC because of acute cholecystitis. The two groups were compared in terms of demographic characteristics, mortality, complications, re-admission, and re-intervention rates. Results: Patients in the PC group were older (78.11±9.76 vs 71.69±12.56 years) and had more frequent comorbidities (99.1% ve 89.7%). Both groups were similar in terms of gender distribution, complication rates and severity (Clavien-Dindo), re-admission rates, and length of stay in hospital. The need for re-intervention was greater in the PC group (30.2% vs.3.4%). Mortality rates were higher in the PC group (40.5% vs.6.9%. Independent predictive factors of mortality were determined to be the application of PC in treatment (odds ratio:8.756) and older age (odds ratio: 1.133). Conclusion: In patients with high-risk acute cholecystitis, EC is superior to PC in terms of lower mortality and reducing the need for re-intervention. Research should be continued for subgroups of patients such as those with biliary sepsis, in intensive care, or with early cholecystectomy bridging.