Mena Boules, MD, Madonna Michael, MD, Essa M Aleassa, MD, MSc, Gareth Morris-Stiff, MD, PhD. Cleveland Clinic
Introduction: Management of malignant biliary obstruction not amenable to surgery is usually by means of ERCP or PTHC. However, on occasions, these routes are not accessible and the alternate decompressive technique of percutaneous cholecystostomy (PC) has to be adopted. The aim of this study was to evaluate the efficacy and outcomes of PC in a highly selected series at a tertiary referral center.
Methods: We retrospectively reviewed all patients that had undergone PC from 2000 to 2014. Data collected included baseline demographics, comorbidities, details of PC placement and management, etiology of MBO, and post-procedure outcomes. The Charlson comorbidity index (CCI) was calculated for all patients at the time of PC.
Results: Four hundred and eight patients underwent PC placement of which 28 patients including 18 (64%) males and 10 (36%) females, with malignant biliary obstruction. The mean age at the time of PC placement was 63.5 ± 11.7 years of age, and the mean CCI was 8.03 ± 2.82 for all patients. of MBO in all 28 patients was due to pancreatic malignancies (n=14), cholangiocarcinoma (n=6), primary hepatic malignancies (n=3), secondary hepatic tumors (n=4), and ampullary carcinoma (n=1). PC tube complications were reported in 7 (25%) patients. Mean number of tube exchanges was 3.4 ± 2.65. Mean duration from PC tube placement to death was 159 ± 159.4 days. 14 total deaths were recorded.
Conclusion: PC placement appears to be a viable option in MBO in elderly and frail patients. In this cohort, PC may be a potential definitive management to improve quality of life.
Presented at the SAGES 2017 Annual Meeting in Houston, TX.
Abstract ID: 87352
Program Number: P090
Presentation Session: iPoster Session (Non CME)
Presentation Type: Poster