TPTh 7.06 Utility of Percutaneous Cholecystostomy in Patients with Acute Cholangitis
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ID: 323885
2026
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Abstract
Abstract Introduction Endoscopic retrograde cholangiopancreatography (ERCP) is first-line treatment for biliary decompression in acute cholangitis (AC). In high-risk patients where ERCP is not feasible or there is lack of availability, percutaneous cholecystostomy (PC) may serve as a good salvage alternative. Our study assessed the effectiveness of PC in this patient cohort in a tertiary centre. Methods A retrospective cohort study of patients undergoing PC for acute AC (April 2015-June 2025) was performed. Data regarding patient characteristics and outcomes was obtained from EPR. Results 39 patients underwent PC for AC. The predominant aetiology of cholangitis was choledocholithiasis (92.3%), followed by stent dysfunction (5.1%) and malignant stricture (2.5%). Using Tokyo classification, AC was severe in 30.7%, moderate (64.1%), and mild (5.1%). ERCP was not performed primarily due to patient instability (74.3%), out-of-hours presentation (28.2%), failed ERCP (12.8%), frailty (10.2%), patient-refusal (2.5%), or gallbladder perforation (2.5%). The median time from diagnosis to PC was 2 days. Clinical success was demonstrated by a reduction in median CRP (266 to 92 mg/L) within 24 hours following PC and a significant decrease in mean NEWS score (6.82 to 2.46) (p < 0.0001). Subsequent ERCP was performed in 66.6% of the patient cohort at a median of 12 days following PC. Overall Thirty-day mortality was 12.8%. Conclusion This is the largest single-centre UK study demonstrating that PC is an effective temporising or salvage intervention for severe AC when ERCP is not immediately feasible/available, supporting its role for high-risk patients and highlighting the need for larger prospective studies.
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| Authors | Ankur Gupta, Muhammad Zain Akhtar, Simon Burbidge, Aaron Wei Heng On, Adam Peckham-Cooper |
| Journal | the british journal of surgery |
| Year | 2026 |
| DOI |
10.1093/bjs/znag087.496
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| Keywords | Keywords not found |
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