422 PECHA study: Percutaneous Cholecystostomy in Acute Cholecystitis

Abstract Aim To evaluate current management patterns for cholecystostomy and identify predictors of post-procedural complications. Method A retrospective review was conducted of all patients who underwent percutaneous cholecystostomy for acute cholecystitis at two UK district general hospitals between 2019 and 2023. Data collected included indication for cholecystostomy, antibiotic duration, drain duration, operator grade and post-procedure complications. Associations between key metrics and outcomes were analysed using chi-square and Fisher’s exact tests (significance p<0.05). Results Eighty-eight patients were included (median age 73, range 30–97). The most common indication for cholecystostomy was as a bridge to cholecystectomy. The median duration of antibiotics prior to intervention was 3 days (range 0–24) and the median drain duration was 28 days (range 7–131). Complications following the procedure were infrequent and included drain migration (7 cases), collection/bile leak (2), bleeding (1), fistula (1), and other specified complications (8). Operator grade was significantly associated with both post-operative (p<0.0001) and post-cholecystostomy complications (p<0.0001). No statistically significant associations were found between complication rates and antibiotic duration, drain duration, or patient age. Conclusions In this cohort, operator grade was the only factor significantly associated with post-procedure complications. No significant relationships were observed between complications and antibiotic duration, drain duration or age highlighting the need for further research into optimal management strategies for cholecystostomy.