PERCUTANEOUS CHOLECYSTOSTOMY

       This is a procedure done to drain the gall bladder by a small tube with radiological assistance. The main indication is that the presence of ongoing infection in the gall bladder like accumulation of pus within the gall bladder with systemic infection and the patient is unfit for any major procedures.

       The procedure is done under sterile condition with local anaesthetic agent injected at the area where the catheter will be inserted. Under ultrasonography guidance, the gall bladder is entered from skin through liver into gall bladder cavity over a guide wire. Once gall bladder is entered, a pigtail catheter is placed from gall bladder cavity to exterior and the drainage fluid will be collected in a bag. This will bring out the infected bile and so the effect of systemic infection will be less and patient starts recovering. Once the patient recovers from the systemic illness, the definitive procedures will be performed.

       This procedure is very useful in very sick patient with features of septicaemia. The contraindications for this percutaneous cholecystostomy are severe coagulopathy, chronic liver disease and ascites.