Objectives:

We aimed to evaluate the results of ultrasound-guided percutaneous cholecystostomy (PC) in geriatric patients with acute cholecystitis.

Methods:

Elderly patients (65 years of age or older) who underwent PC for acute cholecystitis were retrospectively reviewed. PC had been performed in patients with high surgical risks due to comorbidities or high American Society of Anesthesiology (ASA) scores. Patients were evaluated for interval cholecystectomy after the acute attack was resolved.

Results:

Twelve patients (7 female, 5 male) were included into the study. Ten patients presented to the hospital with acute cholecystitis, while acute cholecystitis developed following endoscopic retrograde cholangiopancreatography in 1 patient and during hospitalization for other morbidities in 1 patient. Ultrasonographic evaluation before PC revealed gallbladder hydrops and thickening of the gallbladder wall in all patients, while cholecystolithiasis in 7 patients, gallbladder sludge in 9 patients, pericholecystic fluid in 3 patients, and pericholecystic abscess in 1 patient were also found. Technical procedure success and clinical improvement were achieved in 100% of patients. No procedure-related or 30-day mortality occurred. Complications (vagal reaction and hepatic collections) were seen in 4 (40%) patients. Interval cholecystectomy was performed in 2 patients after the acute attack had resolved. Patients who did not undergo surgery did not show recurrence of acute cholecystitis during the short-term follow-up.

Conclusion:

Ultrasound-guided PC is a successful and safe procedure in the treatment of acute cholecystitis in geriatric patients. Elective surgery can be performed with lower risk rates once the clinical condition improves.

Keywords: Geriatrics, gallbladder diseases, acute cholecystitis, cholecystostomy, drainage