eMedicine Specialties > Clinical Procedures > Gastrointestinal Procedures

Percutaneous Cholecystostomy

Author: Atif Rana, MBBS, Assistant Professor, Department of Radiology, Shifa College of Medicine, Islamabad, Pakistan
Contributor Information and Disclosures

Updated: Jan 22, 2010

Introduction

Over the past few decades, biliary interventions have evolved a great deal. Opacification of the biliary system was first reported in 1921 with direct puncture of the gallbladder. Subsequent reports described direct percutaneous biliary puncture. The technique was revolutionized in 1960s with the introduction of fine-gauge (22- to 23-gauge) needles.

During the 1970s, percutaneous biliary drainage (PBD) for obstructive jaundice and percutaneous treatment of stone disease was introduced. Percutaneous cholecystostomy was first described in the 1980s. With the advent of metallic and plastic internal stents, further applications in the treatment of biliary diseases were developed.
 
Current percutaneous biliary interventions include percutaneous transhepatic cholangiography (PTC) and biliary drainage to manage benign1 and malignant obstruction and percutaneous cholecystostomy.2 Percutaneous treatment of biliary stone disease with or without choledochoscopy is still performed in selected cases. Other applications include cholangioplasty for biliary strictures, biopsy of the biliary duct, and management of complications from laparoscopic cholecystectomy and liver transplantation.

This article outlines the procedure for percutaneous cholecystostomy. For descriptions of other biliary interventions, see eMedicine articles Percutaneous Cholangiography, Percutaneous Biliary Drainage, and Biliary Stenting.

Indications

  • Cholecystostomy is used as a temporizing measure in critically ill patients with acute cholecystitis who cannot undergo cholecystectomy. After the symptoms resolve and the patient's condition is stabilized, definite treatment is still gallbladder removal.
  • In acalculous cholecystitis, percutaneous drainage may be the only treatment required.

More on Percutaneous Cholecystostomy

Overview: Percutaneous Cholecystostomy
Treatment & Medication: Percutaneous Cholecystostomy
Multimedia: Percutaneous Cholecystostomy
References
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References

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  2. Link BC, Yekebas EF, Bogoevski D, et al. Percutaneous transhepatic cholangiodrainage as rescue therapy for symptomatic biliary leakage without biliary tract dilation after major surgery. J Gastrointest Surg. Feb 2007;11(2):166-70. [Medline].

  3. Faylona JM, Qadir A, Chan AC, Lau JY, Chung SC. Small-bowel perforations related to endoscopic retrograde cholangiopancreatography (ERCP) in patients with Billroth II gastrectomy. Endoscopy. Sep 1999;31(7):546-9. [Medline].

  4. Gabelmann A, Hamid H, Brambs HJ, Rieber A. Metallic stents in benign biliary strictures: long-term effectiveness and interventional management of stent occlusion. AJR Am J Roentgenol. Oct 2001;177(4):813-7. [Medline].

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  8. Kaskarelis IS, Papadaki MG, Papageorgiou GN, Limniati MD, Malliaraki NE, Piperopoulos PN. Long-term follow-up in patients with malignant biliary obstruction after percutaneous placement of uncovered wallstent endoprostheses. Acta Radiol. Sep 1999;40(5):528-33. [Medline].

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  10. Bakkaloglu H, Yanar H, Guloglu R, et al. Ultrasound guided percutaneous cholecystostomy in high-risk patients for surgical intervention. World J Gastroenterol. Nov 28 2006;12(44):7179-82. [Medline].

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  12. Baijal SS, Dhiman RK, Gupta S, et al. Percutaneous transhepatic biliary drainage in the management of obstructive jaundice. Trop Gastroenterol. Oct-Dec 1997;18(4):167-71. [Medline].

  13. Becker CD, Glattli A, Maibach R, Baer HU. Percutaneous palliation of malignant obstructive jaundice with the Wallstent endoprosthesis: follow-up and reintervention in patients with hilar and non-hilar obstruction. J Vasc Interv Radiol. Sep-Oct 1993;4(5):597-604. [Medline].

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  21. Gazzaniga GM, Faggioni A, Bondanza G, Bagarolo C, Filauro M. Percutaneous transhepatic biliary drainage--twelve years' experience. Hepatogastroenterology. Apr 1991;38(2):154-9. [Medline].

  22. Harbin WP, Mueller PR, Ferrucci JT Jr. Transhepatic cholangiography: complicatons and use patterns of the fine-needle technique: a multi-institutional survey. Radiology. Apr 1980;135(1):15-22. [Medline].

  23. Hatjidakis AA, Karampekios S, Prassopoulos P, et al. Maturation of the tract after percutaneous cholecystostomy with regard to the access route. Cardiovasc Intervent Radiol. Jan-Feb 1998;21(1):36-40. [Medline].

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  29. Mueller PR, vanSonnenberg E, Ferrucci JT Jr, et al. Biliary stricture dilatation: multicenter review of clinical management in 73 patients. Radiology. Jul 1986;160(1):17-22. [Medline].

  30. Schoder M, Rossi P, Uflacker R, et al. Malignant biliary obstruction: treatment with ePTFE-FEP- covered endoprostheses initial technical and clinical experiences in a multicenter trial. Radiology. Oct 2002;225(1):35-42. [Medline].

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Further Reading

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Keywords

percutaneous cholecystostomy, biliary tract, biliary interventions, percutaneous cholangiography, percutaneous transhepatic cholangiography, PTC, percutaneous biliary drainage, PBD, biliary stenting, biliary stent placement, endoscopic retrograde cholangiopancreatography, ERCP

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Contributor Information and Disclosures

Author

Atif Rana, MBBS, Assistant Professor, Department of Radiology, Shifa College of Medicine, Islamabad, Pakistan
Atif Rana, MBBS is a member of the following medical societies: Radiological Society of North America
Disclosure: Nothing to disclose.

Medical Editor

Gary P Siskin, MD, Professor and Chairman, Department of Radiology, Albany Medical College
Gary P Siskin, MD is a member of the following medical societies: American College of Radiology, Cardiovascular and Interventional Radiological Society of Europe, Radiological Society of North America, and Society of Interventional Radiology
Disclosure: Nothing to disclose.

Pharmacy Editor

Bernard D Coombs, MB, ChB, PhD, Consulting Staff, Department of Specialist Rehabilitation Services, Hutt Valley District Health Board, New Zealand
Disclosure: Nothing to disclose.

Managing Editor

Douglas M Coldwell, MD, PhD, Professor of Radiology, Director, Division of Vascular and Interventional Radiology, University of Louisville School of Medicine
Douglas M Coldwell, MD, PhD is a member of the following medical societies: American Association for Cancer Research, American College of Radiology, American Heart Association, American Physical Society, American Roentgen Ray Society, Society of Cardiovascular and Interventional Radiology, Southwest Oncology Group, and Special Operations Medical Association
Disclosure: Sirtex, Inc. Consulting fee Speaking and teaching

CME Editor

Robert M Krasny, MD, Resolution Imaging Medical Corporation
Robert M Krasny, MD is a member of the following medical societies: American Roentgen Ray Society and Radiological Society of North America
Disclosure: Nothing to disclose.

Chief Editor

Kyung J Cho, MD, FACR, William Martel Professor of Radiology, Interventional Radiology Fellowship Director, University of Michigan Health System
Kyung J Cho, MD, FACR is a member of the following medical societies: American College of Radiology, American Heart Association, American Medical Association, American Roentgen Ray Society, Association of University Radiologists, and Radiological Society of North America
Disclosure: Nothing to disclose.

 
 
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