The impact of routine cholangiography for asymptomatic patients after cholecystostomy insertion for acute cholecystitis

Background: We aim to investigate the impact of routine cholangiography on asymptomatic patients with percutaneous cholecystostomy (PCC) for acute cholecystitis (AC). Methods: The study included all patients treated with PCC for AC from 2017 to 2020 ​at a single academic center. Patients who underwent routine cholangiography within 30 days post-discharge while asymptomatic were compared to patients who were only followed clinically. Results: The groups (cholangiography group, n ​= ​44, and control group, n ​= ​145) were similar in terms of age, comorbidities, and clinical presentation. The readmission rate for biliary disease in the cholangiography group was nearly half that of the control group (22.7 ​% vs. 40.7 ​%, p ​= ​0.05) over an average follow-up of 10.4 months. The time to drain removal, cholecystectomy rate, and time to operation were comparable between the groups (42 vs. 40 days, p ​= ​0.47, 52.3 ​% vs 53.1 ​%, p ​= ​NS and 69 vs. 82 days, p ​= ​0.17, respectively). Conclusions: Routine cholangiography can help reduce biliary disease readmissions among asymptomatic patients with PCC for AC without delaying further treatment.