Abstract

Acute cholecystitis ranges from mild forms that improves with medical treatment alone to severe and complicated ones which may prove fatal that may require intensive care and urgent intervention. Percutaneous cholecystostomy is a technique that consists of percutaneous placement of a catheter under imaging guidance, in the gallbladder lumen was devised which decompresses the gall bladder and improves the patient condition. Aim: Aim of the present study is to assess clinical outcome of patients with acute severe gall bladder diseases treated by percutaneous cholecystostomy in terms Symptomatic relief and Complications following the procedure. Design: prospective observational study. Material and Methods: This study was conducted in Post Graduate Department of General Surgery, SMHS Hospital, Govt. Medical College, Srinagar on 24 patients with severe acute gall bladder diseases who underwent percutaneous cholecystostomy january 2021 to january 2022. Results: 22 patients(91.67%) presented with pain upper abdomen, vomiting in 19 patients(80.55%), and abdominal swelling/lump in 23 (95.8%). Fever was present in 17 patients(70.8.44%). 16 patients (66.7%) had empyema- gallbladder, 4 (16.7%) had mucocele of gallbladder and 4 (16.7%) patients acute acalcular cholecystitis. 17 (70.8%) patients were hypertensives, 14 (58.3%) patients were diabetics, 13 (54.1%) patients had exacerbation of COPD, 10 (41.6%) patients were hypothyroid, 10 (41.6%) patients had CHF, 4 (16.67%) CKD, 3(13.89%) had cirrhosis and 2(11.1%)AF. 21 out of 24 were done via trans-peritoneal route. At admission 6(25%) patients were having moderate pain and 18(75%) patients were having severe pain. While as after 48 hours of procedure there was no pain in 10 (41.6%) patients while 14 (58.3%)patients were having mild pain.(p value <0.0001). No major complication was recorded. Catheter was removed after a mean of 25.25 days (range 17-35 days). Conclusion: Ultrasound guided percutaneous cholecystostomy is a safe and effective procedure for treating high-risk patients with acute severe complicated cholecystitis.

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