SP 2.14 Local Usage and Governance of Cholecystostomy Tube Management for Acute Cholecystitis

Aims

To evaluate local use of cholecystostomy tubes for acute cholecystitis and assess governance, documentation and adherence to recommended post-procedure management in a UK district general hospital.

Methods

A retrospective service evaluation was undertaken of all patients undergoing cholecystostomy tube insertion for acute cholecystitis during 2025. Data collected included patient demographics, discharge documentation, follow-up arrangements, use of tubography, tube-related complications and timing of tube removal. Management was assessed against guidance produced by the International Delphi consensus on the management of percutaneous cholecystostomy.

Results

Sixteen patients underwent cholecystostomy tube insertion, representing <0.1% of biliary admissions. The cohort was predominantly male (75%) with a median age of 79 years (range 57–93). Only nine patients had tubography arranged prior to discharge and eight had formal outpatient follow-up booked.

A clearly documented plan for tube clamping and removal was present in six cases. Tube displacement occurred in six patients. Time from insertion to removal varied widely, with prolonged dwell times observed in several patients. Despite completion of electronic discharge summaries in most cases, documentation of post-procedure responsibility and follow-up was inconsistent.

Conclusions

Management of cholecystostomy tubes for acute cholecystitis demonstrates significant variability and limited adherence to recommended standards. Inconsistent documentation and follow-up planning represent a governance risk in a frail patient cohort. Introduction of a standardised local policy defining ownership, follow-up and tube removal pathways may improve patient safety and is likely to be generalisable to other UK district general hospitals.