Percutaneous Cholecystostomy

Abstract

Using portable ultrasound equipment and the Seldinger technique, a drainage catheter can be placed in a transhepatic fashion into the gallbladder to achieve immediate drainage and decompression. A curved probe starting at a frequency of 3.5 MZh and adjusting per body habitus is recommended. The transhepatic approach is favored over the transperitoneal route to reduce the risk of bile leakage into the peritoneal cavity and to better anchor the catheter. However, with the transhepatic approach there is an increased risk of hemorrhage and future catheter manipulations are more difficult. While the transperitoneal route does in fact have a lower risk of hemorrhage, it is associated with an increased risk of bile leakage and damage to the adjacent hollow viscus.