Ultrasound-guided percutaneous cholecystostomy for acute cholecystitis: a systematic review and meta-analysis.

BACKGROUND

Ultrasound-guided percutaneous cholecystostomy (US-PC) is widely used in high-risk surgical patients with acute cholecystitis. Still, success and safety rates specific to US guidance are not always distinguished within mixed 'image-guided' series.

OBJECTIVE

To estimate technical success, clinical success, and major complication rates of US-PC.

METHODS

Primary studies explicitly reporting US-PC or with separable data were included.

PRIMARY OUTCOMES: technical success, clinical success (as defined by the study), and major adverse events (AEs). Single-arm meta-analysis using random-effects (logit, continuity correction); heterogeneity by I2 and prediction interval.

RESULTS

Four eligible single-arm studies for technical success (N = 466). Pooled technical success 99.3% (95%CI 97.8-99.8; I2 = 0%). Three studies (N = 223) reported clinical success: pooled 97.6% (95%CI 83.4-99.7; I2≈64% due to varying definitions). Two studies (N = 293) reported major AEs: pooled 1.7% (95%CI 0.7-4.1; I2 = 0%). Thirty-day mortality is available from one large study (6.2%).

CONCLUSIONS

In high-risk patients, US-PC demonstrates very high technical success and low major complication rates; clinical success is high but variably defined across studies. Further direct comparisons and standardized definitions are warranted.