Image-Guided Cholecystostomy Tube Placement: Short- and Long-Term Outcomes of Transhepatic Versus Transperitoneal Placement
- 1 January 2019
- journal article
- research article
- Published by American Roentgen Ray Society in American Journal of Roentgenology
- Vol. 212 (1), 201-204
- https://doi.org/10.2214/ajr.18.19669
Abstract
OBJECTIVE. Image-guided percutaneous cholecystostomy may be performed by a transhepatic or transperitoneal approach. We compared the short- and long-term outcomes of percutaneous cholecystostomy related to route of catheter placement. MATERIALS AND METHODS. A retrospective observational study of image-guided percutaneous cholecystostomy was performed from 2004 to 2016. A search of the hospital's radiology information service was performed using the keywords “percutaneous cholecystostomy,” “gallbladder drain,” and “cholecystostomy tube” and the relevant Current Procedural Terminology codes. All search results were reviewed to identify the cohort of 373 patients who underwent initial percutaneous cholecystostomy catheter placement. Imaging was reviewed to determine the method and route of percutaneous cholecystostomy and complications. A chart review was performed to determine clinical outcomes. Differences were examined using a generalized linear model assuming a binary distribution and logit function. RESULTS. Percutaneous cholecystostomy catheter placement was performed using ultrasound guidance alone in 229 patients, ultrasound access with fluoroscopic guidance in 129 patients, CT guidance in 14 patients, and fluoroscopic guidance in one patient. The trocar technique was used for 183 patients, and the Seldinger technique was used for 190 patients. Two hundred eighteen percutaneous cholecystostomy catheters were placed via the transhepatic route, and 153 were placed via the transperitoneal route. The most common catheter sizes used were 8.5-French (n = 234) and 10-French (n = 124). No significant differences were observed between transperitoneal and transhepatic placement with regard to the frequency of pain, clogging, skin infection, bleeding, biloma, cholangitis, leakage, abscess, unplanned catheter removal, or need for replacement (p > 0.05). CONCLUSION. No evidence of a difference in outcomes was observed for transhepatic cholecystostomy tube placement over transperitoneal placement. The route that appears safer and less technically challenging should therefore be chosen.Keywords
This publication has 11 references indexed in Scilit:
- Long-Term Outcomes of Patients with Acute Cholecystitis after Successful Percutaneous Cholecystostomy Treatment and the Risk Factors for Recurrence: A Decade Experience at a Single CenterPLOS ONE, 2016
- Technique and indications of percutaneous cholecystostomy in the management of cholecystitis in 2014Journal of Visceral Surgery, 2014
- Percutaneous cholecystostomy: The radiologist's role in treating acute cholecystitisClinical Radiology, 2013
- A nationwide examination of outcomes of percutaneous cholecystostomy compared with cholecystectomy for acute cholecystitis, 1998–2010Surgical Endoscopy, 2013
- National Trends in Percutaneous Cholecystostomy Between 1994 and 2009: Perspectives From Medicare Provider ClaimsJournal of the American College of Radiology, 2012
- Management of Acute Calculous Cholecystitis in High-Risk PatientsSurgical Laparoscopy, Endoscopy & Percutaneous Techniques, 2005
- Maturation of the Tract After Percutaneous Cholecystostomy with Regard to the Access RouteCardioVascular and Interventional Radiology, 1998
- Percutaneous cholecystostomy for patients with acute cholecystitis and an increased surgical riskCardioVascular and Interventional Radiology, 1996
- Percutaneous Cholecystostomy: Safety of the Transperitoneal RouteJournal of Vascular and Interventional Radiology, 1994
- Percutaneous Cholecystostomy and Cholangiography in Patients with Obstructive JaundiceRadiology, 1979