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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.
Biliary endoscopic sphincterotomy is sometimes used, with or without stenting, to relieve the obstruction, but systematic reviews have not demonstrated consistent benefits. [ 5 ] Treatment of sphincter of Oddi dysfunction: this is a diagnosis of exclusion which encompasses a broad spectrum of hepatobiliary disorders including spasms, strictures ...
Choledochoduodenostomy (CDD) is a surgical procedure to create an anastomosis, a surgical connection, between the common bile duct (CBD) and an alternative portion of the duodenum. [1] In healthy individuals, the CBD meets the pancreatic duct at the ampulla of Vater , which drains via the major duodenal papilla to the second part of duodenum. [ 2 ]
The procedure does come with significant risks and complications—in one retrospective study of patients who received percutaneous cholecystostomy for acute cholecystitis, 44% developed choledocholithiasis (one or more stones stuck in the common bile duct), 27% had tube dislodgment, and 23% developed postoperative abscess.
Low osmolar contrast medium is used in this procedure with concentration of 150 mg/ml with 20 to 60 ml volume. Those who undergoes the procedure needs to be fasted for four hours before the procedure. Besides, antibiotics such as ciprofloxacin 500 mg to 750 mg can be given as antibiotic prophylaxis to prevent infection during the procedure.
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