Acute cholecystitis during the COVID-19 pandemic: is percutaneous cholecystostomy a good alternative for treatment?

Abstract

Aim: To evaluate the efficacy, safety, and results of percutaneous cholecystostomy in patients with acute cholecystitis diagnosed with COVID-19. Material and Method: The demographic characteristics, comorbidities, and acute cholecystitis grading of patients according to the Tokyo guideline 2018 (TG18) were evaluated. Mortality, laboratory parameters, radiological findings, physical status scores according to the American Society of Anesthesiologists (ASA) assessment, and the Charlson Comorbidity Index (CCI) were retrospectively evaluated in a total of 38 patients who underwent percutaneous cholecystostomy. Results: The mean age of the 38 patients was 75±9 years, and 21 (55.3%) were female and 17 (44.7%) were male. According to TG18, 33 (86.8%) of the patients had grade II and five (13.2%) had grade III cholecystitis, while there was no grade I case. The mean CCI of the patients was 7.32±2.1. The ASA scores were mostly IIIE, followed by IIE. The COVID-19 test was positive in 33 (86.8%) of the patients. Mortality developed in four (10.5%) patients during hospitalization. Conclusion: Percutaneous cholecystostomy can be considered as a safe, effective, and alternative method in the treatment of patients with acute cholecystitis.

Keywords

• Acute cholecystitis
• COVID-19
• Percutaneous cholecystostomy

References

1. Ansaloni L, Pisano M, Coccolini F, et al. 2016 WSES guidelines on acute calculous cholecystitis. World J Emerg Surg 2016; 11: 1-23.
2. Yokoe M, Hata J, Takada T, et al. Tokyo Guidelines 2018: diagnostic criteria and severity grading of acute cholecystitis (with videos). Journal of Hepato‐biliary‐pancreatic Sci 2018; 25: 41-54.
3. Stavridis K, Liosis I, Konstantinidis MK, Kondylis G, Ioannidis A. COVID-19 and Acute Cholecystitis Management: A Systematic Review of Current Literature. Front Surg 2022; 9: 871685.
4. Karaca AS, Özmen MM, Uçar AD, Yastı AÇ, Demirer S. COVID-19’lu hastalarda genel cerrahi ameliyathane uygulamaları. Turk J Surg 2020; 36: 6-10.
5. Antunes D, Lami M, Chukwudi A, et al. COVID-19 infection risk by open and laparoscopic surgical smoke: a systematic review of the literature. The Surgeon 2021; 19: e452-e61.
6. Rotzinger D, Beigelman-Aubry C, Von Garnier C, Qanadli S. Pulmonary embolism in patients with COVID-19: time to change the paradigm of computed tomography. Thromb Res 2020; 190: 58-9.
7. Ai T, Yang Z, Hou H, et al. Correlation of chest CT and RT-PCR testing in coronavirus disease 2019 (COVID-19) in China: a report of 1014 cases. Radiology 2020: 200642.
8. Wu C, Chen X, Cai Y, et al. Risk factors associated with acute respiratory distress syndrome and death in patients with coronavirus disease 2019 pneumonia in Wuhan, China. JAMA Int Med 2020; 180: 934-43.

9. Loozen CS, van Santvoort HC, van Duijvendijk P, et al. Laparoscopic cholecystectomy versus percutaneous catheter drainage for acute cholecystitis in high risk patients (CHOCOLATE): multicentre randomised clinical trial. BMJ 2018; 363: k3965.
10. COVID, ACS. 19: elective case triage guidelines for surgical care. ACS website Published March. 2020: 24.
11. Ding BTK, Tan KG, Oh JY-L, Lee KT. Orthopaedic surgery after COVID-19–a blueprint for resuming elective surgery after a pandemic. Int J Surg 2020; 80: 162-7.
12. Zheng MH, Boni L, Fingerhut A. Minimally invasive surgery and the novel coronavirus outbreak: lessons learned in China and Italy. Ann Surg 2020; 272: e5-e6.
13. Shakir T, Matwala K, Vasan A, Karamanakos S. Percutaneous cholecystostomy for acute cholecystitis: a three-year single-centre experience including during COVID-19. Cureus 2021; 13: 12.
14. Griniatsos J, Petrou A, Pappas P, et al. Percutaneous cholecystostomy without interval cholecystectomy as definitive treatment of acute cholecystitis in elderly and critically ill patients. Southern Med J 2008; 101: 586-90.
15. Winbladh A, Gullstrand P, Svanvik J, Sandström P. Systematic review of cholecystostomy as a treatment option in acute cholecystitis. HPB 2009; 11: 183-93.