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Cholecystostomy or (cholecystotomy) is a medical procedure used to drain the gallbladder through either a percutaneous or endoscopic approach. The procedure involves creating a stoma in the gallbladder, which can facilitate placement of a tube or stent for drainage, first performed by American surgeon, Dr. John Stough Bobbs, in 1867.
The function of the common bile duct is to allow bile to travel from the gallbladder to the small intestine, mixing with pancreatic digestive enzymes along the way. [4] One possible complication of choledocholithiasis is an infection of the bile ducts between the liver and the gallstone lodged in the common bile duct.
A surgically created passage between the common bile duct and the jejunum in a procedure called a choledochojejunostomy, can be carried out to relieve the symptoms of biliary obstruction as well as allows the bile duct to drain. [5] In infants with biliary atresia, hepatoportoenterostomy is an alternative method of providing bile drainage.
The gallbladder has a capacity of about 50 millilitres (1.8 imperial fluid ounces). [2] The gallbladder is shaped like a pear, with its tip opening into the cystic duct. [4] The gallbladder is divided into three sections: the fundus, body, and neck. The fundus is the rounded base, angled so that it faces the abdominal wall.
The common hepatic duct is the first part of the biliary tract. [2] It is formed by the union of the right hepatic duct (which drains bile from the right functional lobe of the liver) and the left hepatic duct (which drains bile from the left functional lobe of the liver). [3] The duct is about 3 cm long. [4]
A closed suction drain is placed posterior to the CDD and left in place for usually a week. [3] If the output is less than 40 cm 3 /day, the drain is removed. [16] It can be sent for a bilirubin and alkaline phosphatase test if there are concerns regarding the output. [5]
Biliary endoscopic sphincterotomy is a procedure where the sphincter of Oddi and the segment of the common bile duct where it enters the duodenum are cannulated and then cut with a sphincterotome, a device that includes a wire which cuts with an electric current (electrocautery).
Passive drains rely on gravity or capillary action to remove fluid, whereas active drains rely on a suction/vacuum force, whether that be through connection to wall suction, a portable suction device, or a bulb that has been squeezed to create a vacuum. Open drains are commonly used for superficial wounds and drain into dressings or a stoma bag.