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Percutaneous Cholecystostomy Catheter Removal and Incidence of Clinically Significant Bile Leaks: A Clinical Approach to Catheter Management

James N. Wise1, Debra A. Gervais, Andrew Akman, Mukesh Harisinghani, Peter F. Hahn and Peter R. Mueller

1 All authors: Department of Radiology, Division of Abdominal Imaging and Intervention, Massachusetts General Hospital, 55 Fruit St., White 270, Boston, MA 02114.



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  		Fig. 1. —72-year-old man in ICU with acute cholecystitis referred for percutaneous cholecystostomy drainage. Sonogram shows thickened gallbladder wall (cursors) and sludge (straight arrow) and shadowing stones (curved arrow) in gallbladder.

 


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  		Fig. 2A. —79-year-old woman in ICU with calculus cholecystitis referred for percutaneous cholecystostomy drainage. Sonogram-guided drainage was performed. Sonogram shows trocar catheter (arrow) in gallbladder.

 


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  		Fig. 2B. —79-year-old woman in ICU with calculus cholecystitis referred for percutaneous cholecystostomy drainage. Sonogram-guided drainage was performed. After deployment of catheter, sonogram shows pigtail (arrow) coiled in gallbladder.

 


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  		Fig. 3. —64-year-old man 4 weeks after gallbladder drainage. Cholangiogram obtained via cholecystostomy catheter shows patent cystic (curved arrow) and common (straight arrow) ducts.

 


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  		Fig. 4. —63-year-old woman 3.5 weeks after gallbladder drainage. Tractogram performed through sheath shows no leak into peritoneum and backflow of contrast material onto skin surface (curved arrow).

 

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