Last Updated on October 30, 2025 by Bilal Hasdemir
At Liv Hospital, our expert teams make sure percutaneous cholecystostomy tube placement is safe and works well. This method is less invasive. It involves putting a tube into the gallbladder through the skin. This helps manage acute cholecystitis in patients who can’t have surgery.
We use live imaging to guide the tube placement. This lowers the risk of sepsis and boosts survival chances. Our goal is to give top-notch care when surgery isn’t possible.
Percutaneous cholecystostomy, or perc chole, is a minimally invasive way to drain the gallbladder. A small tube is inserted through the skin into the gallbladder. This helps relieve blockages and infections.
This procedure involves placing a drainage catheter into the gallbladder under imaging. It’s great for high-risk patients who can’t have surgery. This is because of health issues or other complications.
Percutaneous cholecystostomy is used for many reasons. It’s mainly for acute cholecystitis, or inflammation of the gallbladder. This is often caused by gallstones. The procedure drains the gallbladder, easing pain, reducing inflammation, and preventing serious problems like gangrene or perforation.
Knowing the gallbladder’s location is key for a successful procedure. It’s under the liver, and its spot can differ from person to person. Accurate imaging is needed to place the catheter correctly and avoid issues.
There are two main ways to do percutaneous cholecystostomy: the transhepatic and the transperitoneal routes. The transhepatic approach goes through the liver, which might lower the risk of bile leaks. The transperitoneal approach goes straight to the gallbladder through the belly. The choice depends on the patient’s body and the doctor’s preference.
Percutaneous cholecystostomy is key for treating acute cholecystitis in high-risk patients. It’s a less invasive option for those who can’t have surgery right away.
Dealing with acute cholecystitis in high-risk patients is tough. These patients often have many health issues, making surgery too risky. Percutaneous cholecystostomy is a lifesaver. It drains the infected gallbladder, lowering the risk of sepsis and improving survival chances.
We choose percutaneous cholecystostomy for patients with severe acute cholecystitis. This includes the elderly, those with heart or lung problems, and those with a high APACHE II score.
Percutaneous cholecystostomy is used in more than just acute cholecystitis. It’s for patients with acute cholangitis, those needing access to the gallbladder for tests or treatments, and those with gallbladder blockages due to cancer.
It’s also for patients waiting for a liver transplant or with severe trauma. In these situations, it helps stabilize the patient until they can get further treatment.
Deciding if percutaneous cholecystostomy is temporary or permanent depends on the patient’s health and situation. For some, it’s a temporary fix to control infection and recover before surgery.
For others, it might be the only treatment option. We look at each patient’s health, the cause of their gallbladder disease, and their life expectancy to decide the best course of action.
Understanding when to use percutaneous cholecystostomy helps us give our patients the best care. It’s a valuable tool, whether used temporarily or as a permanent solution.
Before starting percutaneous cholecystostomy, it’s key to know the risks and who should avoid it. This method saves lives but comes with its own set of dangers.
Some conditions make percutaneous cholecystostomy too risky. These include unfixable blood clotting problems and severe bleeding disorders. People with these issues face a higher chance of serious problems.
Other conditions might make the procedure risky but not impossible. These include a lot of fluid in the belly, masses in the liver or outside it, and low platelet counts. It’s important to carefully weigh these factors before moving forward.
Assessing a patient’s health and risks is a big part of deciding if percutaneous cholecystostomy is right for them. We look at their overall health, lab results, and other important health signs.
Studies have shown that percutaneous cholecystostomy is safe and effective, even for those at high surgical risk. We use this information to decide if it’s a good option for our patients.
To do a percutaneous cholecystostomy, doctors need special tools and supplies. The process uses advanced imaging and precise instruments for safety and accuracy.
Real-time imaging is key for placing the percutaneous cholecystostomy tube. We mainly use ultrasound or fluoroscopy. Ultrasound shows the gallbladder and nearby areas in real-time. Fluoroscopy helps see the needle and catheter as they are placed.
The procedure needs a clean setup and specific tools. We use a needle for the first step, a guidewire for the catheter, and a dilatator to make the tract bigger. We also use local anesthesia and sedation to keep the patient comfortable.
Choosing the right drainage catheter is very important. We look at size, material, and design. Catheters are usually 6.5 to 8 French in size. For example, a 6.5 French locking loop nephrostomy catheter or an 8 French paediatric nephrostomy percutaneous access set might be used, based on the patient and the procedure’s needs.
By picking the right tools and supplies, we make sure the percutaneous cholecystostomy tube placement is safe and works well.
Getting ready for a percutaneous cholecystostomy tube placement is key. It involves many steps to make sure everything goes well. This preparation makes the procedure safer and helps patients get better faster.
Before starting, patients get lab tests and imaging to check their health and gallbladder. They might have:
These tests give important info. They help doctors plan the procedure and prepare for any problems.
| Laboratory Test | Purpose |
| Complete Blood Count (CBC) | Evaluate for signs of infection or inflammation |
| Coagulation Studies | Assess bleeding risks |
| Liver Function Tests | Evaluate the liver’s condition |
Using antibiotics before the procedure is very important. It helps prevent infections. Doctors choose the right antibiotic based on the patient’s allergies, local resistance, and the procedure’s needs.
Key considerations for antibiotic prophylaxis include:
Managing blood clotting is critical to avoid bleeding. Doctors check the patient’s blood and fix any problems before starting.
Patients on blood thinners might need to stop them or change their dose. This is decided with their doctor.
Talking to patients about the procedure is very important. It makes sure they know the risks, benefits, and other options. This includes discussing:
We focus on educating and supporting patients. This makes them feel more at ease and informed.
Patients can help by wearing loose clothes and bringing their medications and allergy list. This makes the procedure go smoothly.
Percutaneous cholecystostomy tube placement needs careful thought about anesthesia and patient positioning. These factors are key to a safe and successful procedure.
The procedure often uses local anesthesia to reduce pain. Local anesthesia involves injecting anesthetic agents, like lidocaine, into the skin and tissues at the insertion site. This method helps avoid the risks of general anesthesia.
Conscious sedation may also be used to make patients more comfortable. Conscious sedation uses sedatives, like midazolam or fentanyl, to relax and reduce anxiety. The sedation level is adjusted so patients can respond and follow commands.
Patient positioning is very important for the procedure. The patient lies on their back on a fluoroscopy table for the best view of the gallbladder. Fluoroscopy allows for real-time monitoring, making the procedure safer and more effective.
“You will lie on your back on a fluoroscopy table and will be awake for the procedure. You may receive pain medication during the procedure,” as is commonly explained to patients undergoing this intervention.
Preparing a sterile field is key to prevent infection. This involves draping the patient and preparing the skin with antiseptic solutions. The team follows strict sterile technique to keep the site clean.
Effective anesthesia, optimal positioning, and careful sterile field preparation lead to a successful procedure.
Percutaneous cholecystostomy via the transhepatic route is a key procedure for patients with acute cholecystitis. It’s for those at high risk for surgery. This method effectively drains the gallbladder, relieving infection and inflammation.
The first step is choosing the right access site. We use ultrasound or CT for imaging guidance. The goal is to enter the gallbladder through the liver, avoiding major vessels and other critical structures.
The procedure has several key steps:
| Step | Description |
| 1 | Local anesthesia administration |
| 2 | Needle advancement under imaging guidance |
| 3 | Guidewire placement and coiling |
| 4 | Tract dilation and catheter placement |
| 5 | Catheter securing and position confirmation |
The transhepatic route has several benefits. It has a lower risk of bowel injury and a more stable catheter position. By going through the liver, we get a more secure access to the gallbladder, reducing the chance of catheter dislodgment.
Key Benefits:
In conclusion, the transhepatic approach for percutaneous cholecystostomy is very valuable. It’s great for managing patients with acute cholecystitis, even those at high risk for surgery. By knowing the steps and benefits, we can give our patients the best care.
Percutaneous cholecystostomy can be done through the transperitoneal approach. This method goes through the peritoneal cavity to reach the gallbladder. It’s an alternative to the transhepatic route.
Choosing the right spot for the transperitoneal approach is key. We use imaging like ultrasound or CT to find the best spot. We aim to avoid major vessels and other important structures.
The spot is usually in the right upper quadrant. We use local anesthesia to reduce pain. Then, we make a small incision for the drainage catheter.
The steps for the transperitoneal approach are:
The transperitoneal approach has several benefits. It can be more direct to the gallbladder in some cases. This is helpful when the gallbladder is very distended or the transhepatic route is not possible.
Key benefits include less risk of bleeding from hepatic vessels. It also makes tube management easier due to a simpler access route.
Understanding both the transperitoneal and transhepatic approaches helps us tailor the procedure for each patient. This way, we can improve outcomes in percutaneous cholecystostomy procedures.
Securing the percutaneous cholecystostomy tube is key to its success. We must ensure it stays in place to avoid problems.
Securing the tube means using a device and dressing after it’s placed. This keeps the tube in the right spot and makes the patient comfortable.
We use a mix of sutures and adhesives to hold the tube. The choice depends on the patient and the doctor’s decision.
After securing, we check the tube’s drainage. We look at the color, consistency, and amount of fluid.
| Drainage Characteristic | Normal Findings | Potential Concerns |
| Color | Yellow or greenish | Bloody or dark |
| Consistency | Thin or slightly thick | Very thick or purulent |
| Amount | Varies, typically moderate | Minimal or excessive |
Right after, we give orders to care for the patient. These include:
Keeping accurate records is vital. We document the procedure, drainage, and orders. This helps with care and legal needs.
Key documentation elements include:
After a percutaneous cholecystostomy, several steps are key for healing and avoiding problems. It’s important to manage the cholecystostomy tube well. This helps the patient recover and get back to normal life.
Looking after the percutaneous cholecystostomy tube is critical. It helps prevent infections and keeps the tube working right. Here are some tips for tube care:
Regular inspection of the tube site is vital. If you see any complications, tell your healthcare provider right away.
Imaging after the procedure is needed to check the gallbladder and tube position. We usually suggest:
Imaging protocols may vary based on the patient’s health and the situation.
Flushing the cholecystostomy tube regularly is key to keeping it open. Use sterile saline solution for flushing. A healthcare professional or trained caregiver should do it.
Teaching patients and their caregivers about tube management at home is important. They need to know:
Clear instructions and a follow-up plan are key. They help patients manage their care well at home.
Percutaneous cholecystostomy is usually safe, but it can have risks. It’s important to know and manage these complications well. This knowledge helps in dealing with them effectively.
Complications from the procedure can include bleeding, infection, and damage to nearby tissues. Bleeding might happen if a blood vessel is injured during the procedure. It’s vital to quickly spot and manage bleeding to avoid serious problems.
Infection is another risk, but it can be lowered with the right antibiotics and clean techniques. If an infection does happen, it must be treated fast with antibiotics and possibly draining any abscesses.
Complications with the tube can include it moving out of place, getting blocked, or leaking. Keeping a close eye on and taking care of the tube is key to avoiding these issues.
If the tube shifts, it needs to be put back in place quickly to keep the drainage working. Blockages can be fixed by flushing the tube, but sometimes it needs to be replaced.
Preventing complications is the best way to manage them. This means choosing the right patients, doing the procedure carefully, and taking good care of them after. Patients should know the signs of trouble, like more pain, swelling, warmth, or redness at the site, and tell their doctor if they see these.
Handling complications well requires teamwork from doctors, surgeons, and other healthcare experts. By knowing the possible problems with percutaneous cholecystostomy and having plans to deal with them, doctors can make sure patients get the best care.
Percutaneous cholecystostomy tube placement is a key method for treating acute cholecystitis in patients at high risk. It is backed by strong evidence showing it works well and is safe. This makes it a vital part of medical care today.
We’ve explained how to do percutaneous cholecystostomy, from when it’s needed to how to care for patients after. We talked about the two main ways to do it: through the liver and through the belly. We also looked at the possible risks.
This procedure, or perc cholecystostomy, is a less invasive option for those who can’t have surgery. Knowing how to place a percutaneous cholecystostomy tube helps doctors give the best care to patients with acute cholecystitis.
In short, percutaneous cholecystostomy is a trusted and effective treatment. It greatly improves patient results. Its role in medical care is clear, and we keep seeing its benefits in treating acute cholecystitis.
Percutaneous cholecystostomy is a minimally invasive procedure. It involves placing a drainage catheter into the gallbladder. This is done to manage acute cholecystitis in high-risk patients who can’t have surgery right away.
It’s mainly for acute cholecystitis in patients at high risk. This includes those with serious health issues, severe inflammation, or other conditions that make surgery risky.
You can’t have it if you have uncorrectable coagulopathy or suspect gallbladder perforation or peritonitis. If you have severe thrombocytopenia, massive ascites, or known gallbladder malignancy, it’s not recommended.
The procedure uses imaging like ultrasound or CT to guide it. It accesses the gallbladder through the liver or directly through the abdomen. Then, a drainage catheter is placed to empty the gallbladder.
The transhepatic approach goes through the liver to the gallbladder. This might lower the risk of bile leakage. The transperitoneal approach goes directly through the abdomen to the gallbladder.
Complications can include bleeding, infection, or injury to organs. There are also tube-related issues like blockage, dislodgement, or leakage around the tube.
After the procedure, tube care is key. This includes regular flushing to prevent blockage and monitoring for infection or tube problems. Follow-up imaging checks the gallbladder’s status.
For some, it’s a temporary solution until they can have surgery. For others, it’s a permanent solution if surgery is not possible due to health issues.
The tube’s stay depends on the patient’s health and the gallbladder’s condition. It’s removed when the inflammation has gone down and there’s no need for drainage anymore.
Antibiotics are vital to prevent infection after the procedure. This is more important for patients showing signs of infection or at high risk of infection.
Pietrangelo, A. (2024). Managing weight loss after gallbladder removal. Medical News Today. Retrieved from