Interventional Radiology: Gallbladder, Bile, Ducts and Liver
Gallbladder Drainage (Cholecystostomy)

Cholecystostomy, a procedure, which allows for percutaneous (through the skin) drainage of the gallbladder is performed on patients with severe infectious gallbladder disease, who are considered poor candidates for surgical removal of the gallbladder due the presence of other serious disease. The procedure is performed by an interventional radiologist under ultrasound or CT imaging guidance.

Once the gallbladder is located under ultrasound and/or CT imaging, the skin is numbed with a local anesthetic and a 1/4 inch incision is made. To avoid spilling infected bile into the abdominal cavity, a hollow needle and a guidewire are advanced under fluoroscopy into the gallbladder through a section of the liver. The needle then is removed, and the catheter (drain) is inserted over the guidewire.

A small amount of contrast is injected to confirm proper position of the drain. The guidewire is removed leaving the catheter in place to drain bile externally into a bag. The drain is left in place for a period of 4 to 6 weeks to ensure that a mature tract (pathway) has formed. The formation of a tract is important to prevent the spill of infected bile upon the drain's removal. Should the patient's medical condition become sufficiently stabilized during this period to allow for surgical removal of the gallbladder, the drain is removed at the time surgery.