HBS can also be used prior to percutaneous cholecystostomy
tube placement to establish that the cystic duct is obstructed, even if AUS findings appear diagnostic of AC.
On the day of admission, a cholecystostomy
tube was placed, and the hepatic artery was embolized with Gelfoam.
Because of his poor medical condition he was not felt to be stable enough to undergo cholecystectomy, so a CT guided cholecystostomy
tube was initially placed to treat his cholecystitis.
A repeat cholecysto-cholangiogram could not be repeated due to technical reasons; hence, a tube cholecystostomy
was performed to drain the obstructed biliary system and to have an access for postoperative cholecysto-cholangiogram.
In this scenario, a wedge liver biopsy should be performed as an aid to diagnosis, the cholangiogram catheter removed, the cholecystostomy
closed, and the operation concluded.
Acute cholecystitis developed, and the patient underwent cholecystostomy
Thirty-six (49%) of the 74 patients had cholecystectomy, and 25 (34%) had cholecystostomy
Nonvascular pediatric IR procedures include enteric access (eg, feeding and percutaneous gastrostomy tube placements), biopsies, diagnostic and therapeutic drainages, percutaneous transhepatic cholangiography and biliary drainage, percutaneous cholecystostomy
, and percutaneous nephrostomy.
The treatment of choice for acute cholecystitis is surgical, but in selected cases conservative treatment followed by elective cholecystectomy later or cholecystostomy
could represent an alternative (2,3).
Ultrasound has been used to guide percutaneous cholecystostomy
in pregnant patients to temporize acute cholecystitis with cholecystostomy
delayed until after birth (Figure 7).