Interventional procedures in the gallbladder

Nonsurgical methods of methods of treating gallstones, contact dissolution and extracorporeal shock wave lithotripsy, increase the demand for gallbladder intervention. It is important to determine the safety of these procedures. Fifty-six procedures were performed in 46 patients. Diagnostic studies included needle aspiration of bile (n = 5) and transcholecystic cholangiography (TCC)(n = 31). Therapeutic procedures, percutaneous cholecystostomy (PC)(n = 20), were performed for biliary decompression or stone dissolution. Guidance was by US and fluoroscopy. All the TCC studies were diagnostic, 22 of 31 patients had normal ducts, one had common bile duct (CBD) stones without dilatation, one had dilated ducts without obstruction, and seven had CBD obstruction. PC was successful in all 20 patients. Ten were thought to have cholecystitis or biliary sepsis. Only four of ten showed significant improvement after PC. Local bile peritonitis occurred in two of 31 patients after TCC. Two of 20 undergoing PC had complications; one had 2-3 hours of abdominal pain, and one had peritonitis lasting for 4 days