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Percutaneous subhepatic cholecystostomy with removable anchor.
1Department of Radiology, Hospital of the University of Pennsylvania, Philadelphia 19104.
AJR. American Journal of Roentgenology
|December 1, 1988
Summary
Percutaneous subhepatic cholecystostomy offers a safer alternative to transhepatic procedures, minimizing liver trauma and sepsis risk. This gallbladder drainage technique, utilizing fundal anchoring, proved safe and effective in 10 patients.
Area of Science:
- Interventional Radiology
- Gastroenterology
- Surgical Innovation
Background:
- Transhepatic cholecystostomy poses risks of liver trauma and sepsis.
- Gallbladder wall invagination and bile leakage are potential complications of percutaneous procedures.
- Alternative techniques are needed for gallbladder drainage in high-risk patients.
Purpose of the Study:
- To evaluate the safety and efficacy of a novel percutaneous subhepatic cholecystostomy technique.
- To describe a method for preventing gallbladder wall invagination and bile leakage.
- To assess the utility of this approach in patients unsuitable for cholecystectomy.
Main Methods:
- Percutaneous subhepatic cholecystostomy was performed in 10 patients.
- The gallbladder fundus was anchored to the abdominal wall using a removable device via a 17-gauge needle system.
- Sonographic and fluoroscopic guidance were employed throughout the procedure.
Main Results:
- The technique was successfully performed in all 10 patients.
- Seven patients underwent gallbladder drainage for suspected empyema.
- Three patients had gallstones extracted; all were poor surgical risks.
- No instances of hypotension, bile leakage, peritonitis, or bleeding were reported.
Conclusions:
- Percutaneous subhepatic cholecystostomy with fundal anchoring is a safe and effective method for gallbladder drainage.
- This technique minimizes liver trauma compared to transhepatic approaches.
- It provides a viable option for managing gallbladder conditions in high-risk patients.