ArticleInternational journal of surgery (London, England)2025
Management of high-surgical-risk patients with acute cholecystitis following percutaneous cholecystostomy: results of an international Delphi consensus study.
Article in International journal of surgery (London, England), 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 13 papers.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
13 citing papers in PubMed.
- Factors Associated with 30- and 90-Day Mortality After Percutaneous Cholecystostomy for Acute Cholecystitis: A Single-Centre Retrospective Cohort Study.Journal of clinical medicine · 2026Article
- Emergency Cholecystectomy in Patients Classified as High Risk According to the Tokyo Guidelines 2018: A Real-World Analysis.Annals of gastroenterological surgery · 2026Article
- Impact of percutaneous cholecystostomy timing on clinical outcomes in moderate-to-severe acute cholecystitis.Irish journal of medical science · 2026Article
- What Does "High Risk" Mean in Surgical Patients?DEN open · 2026Article
- Gut Microbiota-Bile Acid Axis in Type 2 Diabetes-Associated Gallbladder Diseases: Mechanisms and Therapeutic Potential.Metabolites · 2026Review
- Efficacy and safety of ultrasound-guided bedside percutaneous cholecystostomy using the transhepatic approach and trocar technique in patients with acute cholecystitis.Diagnostic and interventional radiology (Ankara, Turkey) · 2026Article
- Optimal timing for cholecystectomy following percutaneous cholecystostomy: insights from a multicenter retrospective cohort study.Updates in surgery · 2026Observational
- Interventional management of acute perforated cholecystitis: When is percutaneous transhepatic cholecystostomy a reasonable therapeutic option?World journal of gastrointestinal surgery · 2026Article
- Acute cholecystitis in older adults with multimorbidity: does surgery offer better outcomes?Hepatobiliary surgery and nutrition · 2025Article
- Value of Percutaneous Transhepatic Gallbladder Drainage for Advanced Acute Cholecystitis as a Bridging Procedure: A Single-Center Retrospective Study.Journal of clinical medicine · 2025Article
- Impact of Discordant Antibiotics on Outcomes After Percutaneous Cholecystostomy for Acute Cholecystitis: A Retrospective Analysis of 184 PCC Patients.Journal of clinical medicine · 2025Article
- Transhepatic versus Transperitoneal Access for Percutaneous Cholecystostomy Remains Controversial: Interventional Radiologists Must Lead the Discussion.Cardiovascular and interventional radiology · 2025Article
- Gaps and insights toward evidence-based management for acute cholecystitis patients at high surgical risk.Endoscopic ultrasoundReview
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
32 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundThe management of high-surgical-risk patients with moderate to severe acute cholecystitis is challenging in clinical practice. Early laparoscopic cholecystectomy is considered the gold standard for patients who do not respond to conservative treatment. However, for those unfit for surgery due to high risk, alternative treatment options, such as percutaneous cholecystostomy (PC), are available. There are no clear guidelines regarding the management of patients following PC. The primary aim of this study was to propose indications for PC in high-surgical-risk patients with acute cholecystitis and to establish management strategies for gallbladder drainage, either as a bridge to surgery or as a definitive treatment, according to available literature. MATERIALS AND
methodsAfter a targeted literature review, International and Italian experts in the field from the Italian Society of Research in Surgery (SIRC) and the Italian Society of Emergency Surgery and Trauma (SICUT) were consulted to provide their evidence-based opinions on the topic. Statements were proposed during subsequent rounds using the Delphi methodology. Ten statements were provided, and the final agreement is presented in this study.
resultsPatients with moderate acute cholecystitis, a Charlson Comorbidity Index (CCI) ≥ 6, and American Society of Anesthesiologists-Performance Status (ASA-PS) ≥ 3 who fail conservative treatment should undergo laparoscopic cholecystectomy as the first-line approach. For those with severe acute cholecystitis at high-surgical risk, percutaneous cholecystostomy is recommended to relieve symptoms within 24-48 hours. Once the infection is controlled, we should assess which patients may be candidates for interval laparoscopic cholecystectomy. For patients selected for surgery, laparoscopic cholecystectomy is recommended at least six weeks after PC placement. In patients not suitable for surgery, such as those with CCI ≥ 6 and ASA-PS ≥ 4, percutaneous cholecystostomy should remain in place for at least three weeks, after which, following radiographic confirmation of biliary tree patency, the tube may be removed.
conclusionsThis consensus, developed through a multidisciplinary collaboration of interventional radiologists, gastroenterologists, and surgeons, provides a clear and practical guide for managing high-risk surgical patients with acute cholecystitis.
Indexed as
Identifiers
What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.