It is an image-guided placement of drainage catheter into gallbladder lumen. This minimally invasive procedure can aid the stabilization of a patient to enable a more measured surgical approach with time for therapeutic planning.
The gallbladder is punctured with an 18 or 19 gauge needle under ultrasound guidance. Bile can then be aspirated for microbiological studies. A 0.035 guidewire is used to exchange the needle for a dilator and an 8 French or larger pigtail drain is placed within the gallbladder. The drain can often be visualized under ultrasound. Aspiration of bile/pus from the drain confirms satisfactory position.
Poor surgical candidate / high-risk patients with acute calculous or acalculous cholecystitis
Unexplained sepsis in critically ill patients (diagnostic for cholecystitis as etiology of sepsis if clinical improvement after cholecystostomy)
Access to or drainage of biliary tree following failed ERCP and PTC
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