Cholecystostomy and transcholecystic biliary access

Area of Science:

• Interventional Radiology
• Gastroenterology
• Minimally Invasive Surgery

Background:

• Percutaneous cholecystostomy is a key procedure for gallbladder decompression.
• It is frequently utilized in critically ill patients with various gallbladder conditions.

Purpose of the Study:

• To review the indications, techniques, and outcomes of percutaneous cholecystostomy.
• To highlight its role in managing gallbladder pathologies and facilitating further interventions.

Main Methods:

• Review of imaging studies (ultrasound, CT, hepatobiliary scans) for procedural planning.
• Utilizing either transhepatic or transperitoneal access routes based on patient factors.
• Employing Seldinger technique or trocar system for gallbladder catheterization.

Main Results:

• Technical success rates exceed 95% with clinical improvement in 56-93% of patients.
• Complication rates are generally low (3-13%), with major complications in less than 5%.
• Mortality is often linked to severe underlying conditions in critically ill populations.

Conclusions:

• Percutaneous cholecystostomy is a safe and effective procedure for gallbladder decompression.
• Careful patient selection and pre-procedural imaging are crucial for optimal outcomes.
• While generally safe, potential complications and sepsis risks in vulnerable patients require consideration.