Comparison of Intraoperative and Postoperative Outcomes of Interval Laparoscopic Cholecystectomy With and Without Prior Percutaneous Cholecystostomy in Patients with Acute Cholecystitis
DOI:
https://doi.org/10.36283/ziun-pjmd14-4/011Keywords:
Cholecystectomy, Laparoscopic, Percutaneous, Acute Cholecystitis, Postoperative Complications, Surgical OutcomesAbstract
Background: Acute cholecystitis (AC) is a common surgical emergency in Pakistan. Laparoscopic cholecystectomy (LC) is the standard treatment, but percutaneous cholecystostomy (PC) is often used in high-risk patients as a temporizing measure before interval LC. The impact of prior PC on operative and postoperative outcomes in our setting remains unclear. The study aimed to compare intraoperative and postoperative outcomes of interval LC performed with and without prior PC in patients with AC.
Methods: This comparative observational study at CMH Lahore (Dec 2024–July 2025) included 120 patients: Group A (LC without prior PC, n = 60) and Group B (LC with prior PC, n = 60). Outcomes included operative time, adhesion severity, subtotal cholecystectomy rates, conversion rates, recovery parameters, and postoperative complications. Statistical analyses used Chi-square and Mann–Whitney U tests, with p < 0.05 considered significant.
Results: Group B patients were significantly older (58.3 ± 10.5 vs 45.6 ± 11.2 years, p < 0.001) and had a higher proportion of ASA II–III status (60.0% vs 33.3%, p = 0.004) compared to Group A. Operative time was shorter in Group B (65.4 ± 12.5 vs 78.9 ± 15.6 minutes, p < 0.001), with fewer cases of severe adhesions (6.7% vs 33.3%, p < 0.001) and a lower rate of subtotal cholecystectomy (3.3% vs 13.3%, p = 0.048). Recovery was faster in Group B, with earlier oral intake, shorter hospital stays (2.8 ± 1.0 vs 4.5 ± 1.4 days, p < 0.001), and lower—but not statistically significant—overall complication rates (5.0% vs 13.3%, p = 0.098).
Conclusion: Prior PC in AC patients was associated with reduced operative difficulty, fewer severe adhesions, shorter operative time, faster postoperative recovery, and fewer complications, although differences in complication rates were not statistically significant. PC remains a safe and effective bridging intervention for selected high-risk patients when immediate LC is not feasible.
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