Abstract
Percutaneous cholecystostomy (PC) is an interventional radiology procedure used to treat gallbladder-related complications in patients who are poor surgical candidates for cholecystectomy. It can be performed via a transperitoneal (TP) or transhepatic (TH) approach, though the literature remains inconclusive on which route is superior. This retrospective chart review assessed complication rates between the two approaches at two Canadian institutions from 2018 to 2022. Patients were included if they were poor surgical candidates, had a condition requiring gallbladder drainage, and underwent a successful PC. Cases were identified using the key term “Gall Bladder Drainage Perc” in the Picture Archiving and Communication System (PACS), with filters for interventional radiology images. Data on complications, such as repeat PC, catheter dislodgement, and sepsis, were collected with up to 12 months of follow-up. Statistical analyses included Fisher’s exact test for categorical outcomes, independent t-tests for continuous variables, and multivariate logistic regression to account for clustering by staff and center, with p < 0.05 considered statistically significant. Of 101 patients included in the final analysis (TP: N = 63; TH: N = 38), no statistically significant differences in complication rates were found between the two groups (all p-values ≥ 0.05). However, significantly more cases were performed via the TP route (p = 0.013). These findings suggest that the PC route may not significantly impact complication rates, challenging previous studies that favor the TH route. PC route selection often depends on the interventional radiologist's preference, anatomy, and clinical context. Further research is warranted to inform future quality improvement endeavors and evidence-based guidelines for PC route selection.
Published on: November 13, 2025
doi: 10.17756/micr.2025-122
Citation: Hopkins R, Hodder A, Dalton A. 2025. A Comparison of Complication Rates Between Transhepatic and Transperitoneal Percutaneous Cholecystostomy Routes in the Treatment of Acute Cholecystitis. J Med Imaging Case Rep 9(2): 48-53.
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