Akut Kolesistitli Hastaların Tedavisinde Perkütan Kolesistostominin Etkinliği ve Klinik Seyri.

Background: In this study, it was aimed to evaluate the efficacy, safety, and clinical results of percutaneous cholecystostomy (PK) in the treatment of patients with acute cholecystitis (AC). Materials and Methods: All patients older than 18 years of age who underwent PC in Mehmet Akif Inan Hospital and Harran University Hospital between January 2020 and May 2022 were analyzed retrospectively. Demographic data (age and gender), comorbidities, duration of catheter removal, length of hospital stay, American Society of Anesthesia (ASA) score, interval cholecystectomy, and mortality development status of the patients were recorded. According to the severity of AC, it was divided into three grade 1 (mild), grade 2 (moderate), and grade 3 (severe). Results: Of the 130 patients included in the study, 76 (58.5%) were female, and the mean age of the patients was 71.9 (range: 36-92) years. The most common comorbidities were hypertension (n=28, 21.5%) and coronary artery disease (n=26, 20.0%). Of the patients, 70 (53.8%) had calculous cholecystitis and 115 (88.5%) had hydropic gallbladder. The ASA score of 68 (52.3%) patients was 3-4 and 14 (10.8%) were grade 3 cholecystitis. The technical success of PK was 100%. The in-hospital mortality rate was 15.4% (n=20), and the mean age of patients who died was significantly higher than those who were discharged (81.2 ± 8.5 and 70.1 ± 13.8 years, p<0.001). The rate of severe (grade 3) AC and high ASA score (ASA 3 and 4) were significantly higher in patients who developed mortality compared to those who were discharged (40% vs. 5.5%, p<0.001 vs. 80% vs. 47.3%, p=0.006; respectively). Patients who died had a longer hospital stay (median value, 28 vs 13 days; p=0.002) and a significantly higher CRP (86.2 ±23.8 vs 11.4 ± 6.4 g/dl; p=0.032). Cholecystectomy was performed in 46.2% (n=60) of the patients after PC. Conclusions: PC can be used effectively and safely in both preoperative bridging and definitive treatment of patients with acute cholecystitis. In addition, it was found that the advanced age of the patients who underwent PC, had a high ASA score due to comorbidity diseases, and the presence of severe cholecystitis increased mortality. [ABSTRACT FROM AUTHOR]