eMedicine Specialties > Clinical Procedures > Gastrointestinal Procedures
Percutaneous Cholecystostomy
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.
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Overview: Percutaneous Cholecystostomy |
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References
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Further Reading
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
Overview: Percutaneous Cholecystostomy