Image-Guided Cholecystostomy Tube Placement : Short- and Long-Term Outcomes of Transhepatic Versus Transperitoneal Placement

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.

Medienart:

E-Artikel

Erscheinungsjahr:

2019

Erschienen:

2019

Enthalten in:

Zur Gesamtaufnahme - volume:212

Enthalten in:

AJR. American journal of roentgenology - 212(2019), 1 vom: 01. Jan., Seite 201-204

Sprache:

Englisch

Beteiligte Personen:

Beland, Michael D [VerfasserIn]
Patel, Lakir [VerfasserIn]
Ahn, Sun H [VerfasserIn]
Grand, David J [VerfasserIn]

Links:

Volltext

Themen:

Cholecystitis
Cholecystostomy
Gallbladder
Gallbladder drainage
Journal Article
Observational Study

Anmerkungen:

Date Completed 23.10.2019

Date Revised 23.10.2019

published: Print-Electronic

Citation Status MEDLINE

doi:

10.2214/AJR.18.19669

funding:

Förderinstitution / Projekttitel:

PPN (Katalog-ID):

NLM28988537X