Percutaneous cholecystomy

Technique that involves puncture of the gallbladder via ultrasonographic or computed tomographic guidance, followed by placement of a pigtail catheter.

This management resolves acute cholecystitis in approximately 90% of patients.

The technique is especially useful in patients who cannot safely undergo laparoscopic cholecystectomy due to dangers of anesthesia, severe cholecystitis, late presentation, or lack of improvement from medical care.

The process of external drainage allows time for local inflammation to subside, systemic symptoms to abate and reduces need for open cholecystomy.

Up to 25% of procedures associated with complications: inadvertent catheter dislodgement, and painful catheter,

The catheter can be removed in 3-6 weeks when acute cholecystitis resolves.

The catheter can be removed if the cystic duct is patent, few gallstones are present, and no bile duct stones are present

The procedure may allow extraction of gallbladder stones and prevent gallbladder surgery.

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