Comparison of Conventional vs. Modified Seldinger Technique in Percutaneous Cholecystostomy and Evaluation of Procedural Efficiency and Safety

Background/Aims: To assess the effectiveness and safety of a modified Seldinger technique (MST), bypassing consecutive dilatation steps, versus the conventional Seldinger technique (CST) in percutaneous cholecystectomy (PC). Methods: We performed a retrospective observational cohort analysis utilizing a de-identified dataset covering a period of 2 years (2021-2023) in a significant tertiary-level healthcare facility in Turkey. Results: 152 individuals underwent successful PC. No significant differences were found regarding demographic, clinical, or laboratory characteristics between the CST and MST groups, indicating comparable patient profiles. The clinical efficacy rates were comparable between the two trial cohorts (85% in the CST versus 88.5 in the MST group; p = 0.547). The MST group had significantly shorter procedural time compared to the CST (4.24 ± 1.52 vs 2.85 ± 1.31, p=0.001). Safety profiles were similar between groups (p = 0.486), with minor bleeding resolving spontaneously in one patient per group and no major complications observed. Pain during the CST procedure was significantly higher than in the MST group, though this difference did not persist at the 12-hour follow-up (p = 0.01and 0.6, retrospectively). Conclusion: The utilization of the MST technique for PC demonstrated comparable efficacy and safety to the CST. However, MST was found to be associated with a lower incidence of complications related to the procedure, and required less time to perform, when compared to the CST.