Ultrasound-Guided Percutaneous Transhepatic Cholecystic Puncture and Suction for Acute Acalculous or Postoperative Cholecystitis

Abstract

As a nonsurgical treatment for acute acalculous or postoperative cholecystitis, ultrasound-guided percutaneous transhepatic cholecystic puncture and suction (PTCPS) has been performed in 24 patients with these diseases over the past 5 years. Cholecystic puncture and suction of the gallbladder contents were performed, followed by cholecystography. An antibiotic was infused into the gallbladder before removal of the puncturing needle. Eight patients received this treatment 2 or 3 times. Among the patients in whom a favorable effect was obtained, 19 were cured of acute cholecystitis by this treatment alone, and 1 recovered from this disease due to the addition of percutaneous cholecystostomy. Of 4 patients in whom there was no effect, 2 were treated with percutaneous cholecystostomy, and 2 underwent cholecystectomy. For all patients exhibiting a positive effect clinical symptoms disappeared, and laboratory data improved. These results suggest that PTCPS may be the procedure of first choice, for this treatment revealed the least invasiveness as a therapeutic means for acute acalculous or postoperative cholecystitis, in addition to its high rate of curing the diseases.