Ultrasound Guided Percutaneous Cholecystostomy.

Study Overview
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Brief Summary
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Surgical cholecystostomy has proven value in the management of both inflammatory and obstructive biliary tract disease

Detailed Description
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The etiology of biliary obstruction can be benign or malignant. Benign disease, such as calculi, strictures, or pancreatitis, can be common causes in adult patients [5], whereas benign strictures including posttransplant anastomotic strictures and strictures secondary to hepatic artery insufficiency, stone disease, infection, and iatrogenic causes can be seen in children [6]. Obstruction can also be seen in the setting of biliary tract abnormalities, such as biliary atresia in neonates and symptomatic choledochal cysts, autoimmune pancreatitis, and sclerosing cholangitis in older children [7]. Biliary obstruction secondary to neoplasm commonly occurs with pancreatic cancer, cholangiocarcinoma, or metastases in adult patients and biliary rhabdomyosarcoma or neuroblastoma in younger patients [8]. The question remains as to whether all patients undergoing PCT drainage require a definitive cholecystectomy. Previous publications have suggested that there is a reluctance to use PCT in older and comorbid patients due to concerns of potentially committing such patients to an interval surgical procedure for which they may not be suitable.

Official Title
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Ultrasound Guided Percutaneous Cholecystostomy as Preoperative Step for Obstructive Gallbladder Diseases.

Conditions
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Gall Bladder Disease

Intervention / Treatment
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* Procedure: pigtail


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Pyocele of the gallbladder Mucocele of the gallbladder Perforated gallbladder Malignant causes of gallbladder obstruction Exclusion Criteria: Uncontrolled bleeding disorders

Ages Eligible for Study
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Minimum Age: 4 Years
Maximum Age: 100 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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Accepts Healthy Volunteers

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Treatment
Intervention Model: Single Group Assignment
Masking: None (Open Label)


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: pyocele<br>obstructed gallbladder with infection on top | Procedure: pigtail<br>* placing a small amount of local anaesthetic subcutaneously at the site of the gallbladder, a skin incision was made through which the catheter was introduced. A 7-Fr pigtail catheter was used in all cases . If possible, the catheter was introduced into the gallbladder after passing through the liver. The catheter was thereafter fixed, either by an internal locking device or by means of a suture to the skin. The catheter was rinsed with saline solution daily in order to prevent clogging.<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| value of cholecystostomy as preoperative step in critically ill patients | The aim of this study was to assess the clinical outcomes of PCT use, with particular emphasis on a subgroup of patients who did not proceed to cholecystectomy. | basline |