Indications for and Optimal Management of Percutaneous Cholecystostomy Drainage

When is percutaneous cholecystostomy (PC) indicated and how should it be managed?In this systematic review, PC was outperformed by cholecystectomy and offered no apparent benefit compared to antibiotic-only management except among patients with concomitant sepsis. A clamp trial was superior to tube cholangiogram when considering tube removal, and laparoscopic interval cholecystectomy (IC) 8-13 weeks following PC was associated with better outcomes compared to a definitive PC.The findings suggest that PC should be used as a bridge to IC and should be considered among patients who will likely become good surgical candidates.

Corresponding Author: Kamal M. F. Itani, MD, Department of Surgery, Veterans Affairs Boston Healthcare System, 1400 VFW Pkwy, West Roxbury, MA 02132 (kamal.itani@va.gov).

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