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Войти в исследования Scandinavian journal of gastroenterology · 2026
Radiologic predictors of early recurrence of acute cholecystitis following percutaneous cholecystostomy tube removal.
СтатьяНазвание и аннотация: Перевод в очереди
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Yu Ji Hoon, Lee Ah Young, Yeon Jae Woo, Kwon Chang-Il, Seo Jun-Young
Аннотация
BACKGROUND: Percutaneous cholecystostomy (PC) is commonly utilized in high-risk patients with acute cholecystitis as either a bridge to surgery or as definitive therapy. However, early recurrence following tube removal remains a significant clinical concern. This study aimed to identify imaging predictors associated with early recurrence after PC tube removal.
METHODS: A total of 1,002 patients who underwent PC between 2008 and 2024 were retrospectively reviewed. Patients who subsequently underwent cholecystectomy (n = 606), were discharged with the tube in place (n = 221), or did not undergo fluoroscopic tube removal (n = 21) were excluded, resulting in 154 patients for analysis. Pre-removal imaging (CT or ultrasound) was assessed for gallbladder wall thickening, pericholecystic fluid, residual stones or sludge, and cystic duct stricture. The primary outcome was recurrence within 30 days of tube removal. Cox proportional hazards models were utilized for analysis.
RESULTS: Early recurrence occurred in 10 patients (6.5%). Cystic duct stricture on fluoroscopy was significantly more frequent in the recurrence group compared with the non-recurrence group (50.0% vs 6.9%, p < 0.001). In multivariate Cox proportional hazards analysis, cystic duct stricture (HR = 17.59, 95% CI 4.19-73.86, p < 0.001) and pancreatobiliary malignancy (HR = 9.34, 95% CI 1.56-56.04, p = 0.01) were identified as independent predictors of early recurrence.
CONCLUSION: Cystic duct stricture identified on fluoroscopic cholangiography represents a strong independent radiologic predictor of early recurrence following PC tube removal, and pancreatobiliary malignancy further contributes to elevated recurrence risk.
METHODS: A total of 1,002 patients who underwent PC between 2008 and 2024 were retrospectively reviewed. Patients who subsequently underwent cholecystectomy (n = 606), were discharged with the tube in place (n = 221), or did not undergo fluoroscopic tube removal (n = 21) were excluded, resulting in 154 patients for analysis. Pre-removal imaging (CT or ultrasound) was assessed for gallbladder wall thickening, pericholecystic fluid, residual stones or sludge, and cystic duct stricture. The primary outcome was recurrence within 30 days of tube removal. Cox proportional hazards models were utilized for analysis.
RESULTS: Early recurrence occurred in 10 patients (6.5%). Cystic duct stricture on fluoroscopy was significantly more frequent in the recurrence group compared with the non-recurrence group (50.0% vs 6.9%, p < 0.001). In multivariate Cox proportional hazards analysis, cystic duct stricture (HR = 17.59, 95% CI 4.19-73.86, p < 0.001) and pancreatobiliary malignancy (HR = 9.34, 95% CI 1.56-56.04, p = 0.01) were identified as independent predictors of early recurrence.
CONCLUSION: Cystic duct stricture identified on fluoroscopic cholangiography represents a strong independent radiologic predictor of early recurrence following PC tube removal, and pancreatobiliary malignancy further contributes to elevated recurrence risk.