Published online Feb 14, 2025. doi: 10.3748/wjg.v31.i6.101163
Revised: November 12, 2024
Accepted: December 19, 2024
Published online: February 14, 2025
Processing time: 126 Days and 18.5 Hours
Percutaneous cholecystostomy (PC) can be used as a bridging therapy for moderately severe acute biliary pancreatitis (MSABP). Currently, there are only a limited number of reports of MSABP using PCs.
To assess the short-term outcomes of early PC in MSABP and factors associated with recurrence and death in MSABP.
Patients who received conservative treatment or PC for acute biliary pancreatitis (ABP) in Liaoning Provincial People’s Hospital from January 2017 to July 2022 were collected. A total of 54 patients with MSABP who received early-stage PC and 29 patients who received conservative treatment. The short-term efficacy of PC was evaluated. Depending on whether there is a recurrence, compare the characteristics of the pre-PC and explore the factors of recurrence. Pre-PC features were compared and predictors were discussed, depending on the outcome.
After 3 days of PC treatment, patients experienced a reduction in inflammatory markers compared to the conservative group. After PC, patients were divided into non-recurrence (n = 37) and recurrence (n = 10) groups, and the results showed that age was an independent correlation affecting ABP recurrence [odds ratio (OR) = 0.937, 95% confidence interval (CI): 0.878-0.999; P = 0.047 < 0.05]. Patient outcomes were divided into non-lethal (n = 47) and lethal (n = 7) groups, and Charlson Comorbidity Index (CCI) was a risk factor for mortality (OR = 2.397, 95%CI: 1.139-5.047; P = 0.021 < 0.05). CCI was highly accurate in predicting death in MSABP (area under the curve = 0.86 > 0.7). When the Youden index maximum was 0.565, the cut-off value was 5.5, the sensitivity was 71.4%, and the specificity was 85.1%.
PC is an important method in the early years (< 72 hours) of MSABP. Age is a protective factor against recurrence of ABP. High pre-PC CCI is significantly associated with mortality.
Core Tip: We conducted a comparison of percutaneous cholecystostomy before treatment with 3 days of treatment, and between the two modalities after 3 days of treatment, and explored the factors associated with the occurrence of recurrence or death after percutaneous cholecystostomy in patients with moderate to severe acute biliary pancreatitis to deepen our understanding of moderate to severe acute biliary pancreatitis.