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< Backgrounds > The aim of the present study is to identify the diagnostic and therapeutic u! efulness of percutaneous transhepatic cholecystoscopic examination (PTCCS) in high-risk si_ rgical patients manifesting acute cholecystitis. < Methods > Between the January 1992 and k ne 1998, 33 consecutive patients who underwent percutaneous transhepatic cholecystostomy (PQ and subsequent PTCCS for the management of acute cholecystitis were included. PC and subsequent PTCCS were successfully accomplished in all of 33 patients. During PTCCS, minor complications (2 of minor bleeding during elctrohydraulic lithotripsy, 2 o ´ tube dislodgement and 1 of bile leakage to peritoneum) occurred in five patients. PTCCS n vealed 26 cases of gallstones, 3 cases of sludge ball, 3 cases of gallbladder carcinoma and 1 case of clonorchiasis related with acute cholecystitis. Three cases of the gallbladder cancers v, hich were not predicted rad:iologically were incidentally found during, PTCCS. For 26 patients with gallstones, PTCCS and concomitant stone removal were successfully carried out it one to four consecutive sessions (mean 2.2 sessions). Gallstones recurred in three (3/22, 14%) patients during the mean follow-up period of 27 months. All of them remain & symptomatic. < Conclusion > PTCCS may be justified in the management of acute c I iolecystitis in selected patients of high surgical risk.
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