What is a cholecystostomy?

The gallbladder is a small sac-like structure under the liver. It stores bile that is secreted into the intestines to help digest fats. Over time, the gallbladder can become obstructed or infected. Treatment usually includes antibiotics and, if necessary, surgical removal. However, sometimes surgery is not an option because the patient is too sick or for other reasons. In these cases, an interventional radiologist will perform a cholecystostomy, a procedure in which a drainage catheter is placed in the gallbladder. This catheter keeps the gallbladder from getting too swollen, until the child is well enough for surgery.

The Procedure

Using ultrasound and live X-ray (fluoroscopy) for guidance, the radiologist will insert a small needle through the skin and into the gallbladder, and then place a tiny catheter into the gallbladder. The catheter will be connected to a drainage bag or bulb, which will be located outside of the body in the right upper abdomen. We will place gauze and clear a bandage over the site. The bandage must remain dry and in place at all times. In addition, the catheter will be secured with a locking device (StatLock®), which must not be removed. The amount of time that the catheter and drainage bag will be in place varies from several days to weeks or longer.

Your child will be protected by an X-ray shield during the procedure.

Anesthesia

Patients receive either IV sedation or general anesthesia and are asleep for this procedure.

Risks

The procedure is considered low-risk. However, potential complications include:

• bleeding
• infection
• injury to the gallbladder
• bile leak (biloma)
• puncture of the lung (very rare)
• allergic reaction to X-ray dye (contrast reaction)
• right shoulder pain (radiating from the liver)

Pain

Some children feel pain or discomfort at the needle-insertion site, usually in the first day or two after the procedure. You may give over-the counter pain medication if the pain lingers on.

Bathing

You may sponge bathe your child, but keep the needle-insertion site dry.

Activity Restrictions

Your child will need to avoid activities that may result in a pull to the catheter.