Interventional Radiology Leaflet: Cholecystostomy (Gallbladder Drain) Insertion

Cholecystostomy (Gallbladder Drain) Insertion: A cholecystostomy is a procedure used to drain the gallbladder when it is inflamed or infected (a condition called cholecystitis).

Leaflet Details

Patient Information

Introduction

This leaflet provides information about the procedure, what to expect on the day, the potential risks and important information for afterwards.

Prior to the procedure, you will have a telephone consultation, where you will have the opportunity to ask further questions.

Please note that this leaflet is not meant to replace discussion between you and your doctor. You should raise any questions you may have with the doctor who has referred you or with the doctor who will be performing the procedure.

What is a cholecystostomy?

A cholecystostomy is a procedure used to drain the gallbladder when it is inflamed or infected (a condition called cholecystitis).

A small tube (drain) is inserted through the skin into the gallbladder to allow infected bile to drain out. This helps relieve pain and treat infection.

The procedure is usually performed using ultrasound and/or X-ray guidance to ensure accurate placement.

Cholecystostomy is often used when surgery to remove the gallbladder is not immediately possible or is considered high risk.

Why do I need a cholecystostomy?

You may be offered this procedure if you have inflammation or infection of the gallbladder, especially if you are not well enough for surgery.

Symptoms of cholecystitis may include:

• Pain in the upper right side of the abdomen
   
• Fever
   
• Nausea and vomiting
   
• Loss of appetite

The procedure helps to drain the infected gallbladder, relieve symptoms and control infection.

How do I prepare for cholecystostomy?

You will have a pre-assessment telephone consultation with a nurse before your admission and may be asked to have blood tests before the procedure.

You should stop eating 6 hours prior the procedure, however you can drink 1 cup of clear water per hour until the procedure starts.

As it’s a day case procedure or a short stay procedure, you need to arrange for an adult to collect you from the department and someone to stay overnight with you.

The procedure will take place in the Interventional Radiology (IR), within the Radiology Department at St. Peter’s Hospital. When you arrive, you will be given a hospital gown to change into, and a nurse will insert an IV cannula.

The doctor will discuss the procedure with you; answer any questions you may have and ask you to sign a consent form if you are happy to proceed.

The procedure will likely be performed under local anaesthetic. Intravenous pain relief and light sedation may also be given, to ensure you are as comfortable as possible.

If you are feeling unwell closer to the day of the procedure, please let the team know.

How is a cholecystostomy performed?

You will usually lie on your back.

Ultrasound and / or X-ray guidance is used to identify the gallbladder. The skin on the right side of your abdomen is cleaned and numbed with local anaesthetic.

A small incision is made, and a needle is inserted into the gallbladder. A guidewire is placed, and a drain is inserted over the wire into the gallbladder.

The drain is connected to a drainage bag, allowing infected bile to drain out.

The procedure usually takes 30 to 60 minutes.

At the end of the procedure, the drain is secured in place and a dressing is applied.

What are the potential risks / complications of a cholecystostomy?

Cholecystostomy is a commonly performed and generally safe procedure. However, as with all medical procedures, there are some risks:

Pain or discomfort

• Common (up to 30-40%)
   
• Usually mild to moderate and managed with pain relief

Bleeding

• Minor bleeding can occur (up to 5-10%)
   
• Significant bleeding is uncommon (1-3%)

Infection or sepsis

• Infection is already present in most cases
   
• Worsening infection or sepsis can occur in approximately 2-5% of patients
   
• Requires prompt treatment

Bile leak

• Leakage of bile around the drain can occur (1-3%)
   
• Usually managed with continued drainage

Drain-related problems

• Blockage, displacement, or leakage around the drain can occur (up to 5-10%)
   
• May require repositioning or replacement

Injury to surrounding structures

• Rare (<1%), including bowel or liver injury

Failure of procedure

• Occasionally, it may not be possible to safely place the drain

Radiation exposure

• If X-ray guidance is used, radiation exposure is kept as low as reasonably achievable

What happens afterwards?

After the procedure, you will be monitored in a recovery area or ward.

• Your blood pressure, pulse, temperature, and comfort will be monitored
   
• You will continue to receive antibiotics
   
• The drain output will be monitored

You will usually need to stay in hospital for observation.

If you are discharged with the drain in place:

• You will be shown how to care for the drain
   
• The drain may remain in place for several weeks

You should:

• Keep the drain site clean and dry
   
• Avoid pulling or dislodging the drain
   
• Follow instructions regarding emptying the drainage bag

Seek urgent medical advice if you experience:

Follow-up

Follow-up will be arranged with your clinical team. In some cases, removal of the gallbladder may be planned once you are well enough.

Contact Details

Interventional Radiology
St Peter’s Hospital
Tel: 01932 723470
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