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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.
Cholecystostomy can be used for people who need immediate drainage of the gallbladder but have a high risk of complications from surgery under general anaesthesia, such as elderly people and those with co-existing illnesses. [52] Draining pus and infected material through the tube reduces inflammation in and around the gallbladder.
Postcholecystectomy syndrome (PCS) describes the presence of abdominal symptoms after a cholecystectomy (gallbladder removal).. Symptoms occur in about 5 to 40 percent of patients who undergo cholecystectomy, [1] and can be transient, persistent or lifelong.
After the surgery, nasogastric suction is usually maintained for 2–3 days and the tube is removed when there is low output. Once the tube is in place, it can be used to give the patient food and medicine. [medical citation needed] A fluid diet is started after surgery and the diet is advanced as tolerated by the patient. [16]
In cases of severe inflammation, shock, or if the person has higher risk for general anesthesia (required for cholecystectomy), an interventional radiologist may insert a percutaneous drainage catheter into the gallbladder (percutaneous cholecystostomy tube) and treat the person with antibiotics until the acute inflammation resolves.
Bile duct obstruction, which is usually present in acute cholangitis, is generally due to gallstones. 10–30% of cases, however, are due to other causes such as benign stricturing (narrowing of the bile duct without an underlying tumor), postoperative damage or an altered structure of the bile ducts such as narrowing at the site of an anastomosis (surgical connection), various tumors (cancer ...
Perforated diverticulitis often requires surgery due to risks of infection or recurrence. Recurrent diverticulitis may required resection even in the absence of perforation. Bowel resection or repair is typically initiated earlier in patients with signs of infection, the elderly, immunocompromised, and those with severe comorbidities. [16]
Chest tube clogging can lead to retained blood around the heart and lungs that can contribute to complications and increase mortality. [11] A common complication after thoracic surgery that arises within 30–50% of patients are air leaks. If a chest tube clogs when there is an air leak the patient will develop a pneumothorax.