Percutaneous transhepatic gallbladder drainage followed by laparoscopic cholecystectomy for acute cholecystitis

Since 1982, there have been numerous clinical reports on the treatment of acute cholecystitis by percutaneous transhepatic gallbladder drainage (PTGBD). This is a retrospective study of acute cholecystitis treated initially with PTGBD followed by laparoscopic cholecystectomy (LC) during the subacute stage. From September 1996 to December 1999, 22 patients critically ill with acute cholecystitis and with symptoms for more than three days were treated first with PTGBD at the National Cheng Kung University Hospital (NCKUH). Subsequently, LC was performed one week after the patients were stabilized with a conversion rate of 32%, showing an acceptable operative morbidity rate and no mortality. In this series, PTGBD, as a life saving-drainage procedure, did not improve the conversion rate of LC in acute cholecystitis, as compared with other series without PTGBD. Performing preoperative PTGBD seems to change the surgical timing in traditional treatment for acute cholecystitis.