Cholecystostomy

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. 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.

How is a cholecystostomy performed?

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 your child’s body, at the right upper abdomen.

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

Will my child be awake for the procedure?

No. We will use either intravenous sedation or general anesthesia so that your child isn’t awake.

What risks are associated with the procedure?

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)

Will my child be in any pain after the procedure?

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

How long will the catheter and drainage bag be in place?

The time varies from several days to weeks or longer.

When can my child shower?

We will place gauze and a clear 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. You may sponge bathe your child, but please keep the site dry.

Are there any activity restrictions?

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


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