Percutaneous Cholecystostomy in Cyprus
Percutaneous Cholecystostomy is a procedure in which Dr Zertalis uses ultrasound (US) and X-Rays (fluoroscopy) to navigate a small plastic tube (drain) through the skin (percutaneous) inside the gallbladder to allow drainage of bile and infected fluid externally into a bag.
Inflammation and accumulation of infected fluid within the gallbladder results in fever, pain, shortness of breath and can lead to organ failure with life-threatening consequences if left untreated.
Drainage of the infected fluid in combination with the use of antibiotics aims at symptom relief and treatment of infection.
Percutaneous cholecystostomy is a safe, effective and accurate procedure, but as with any medical procedure there are some risks and complications that you may uncommonly experience.
Bleeding: Risk of bleeding that is significant following percutaneous drainage is very small. Uncommonly, a blood transfusion may be required and rarely an interventional radiological or surgical procedure may be necessary to stop ongoing bleeding.
Re-accumulation of fluid: In some patients, fluid re-accumulates and in this instance a repeat procedure maybe necessary. You can discuss this in detail with Dr Zertalis.
Bile leak: This uncommon complication may occur if bile leaks from the gallbladder into the abdomen resulting in pain and collection of bile in the abdomen (biloma). A procedure will likely be necessary to drain the collection.
Dr Zertalis will explain the procedure and ask you to sign a consent form. Please feel free to ask any questions that you may have and remember that even at this stage, you can still decide not to go ahead with procedure if you choose to do so.
Before the procedure
Relevant bloods test will be undertaken before the procedure and if your blood clotting is abnormal, blood transfusion may be necessary to correct this. If you have any concerns about having a blood transfusion, you should discuss these with Dr Zertalis.
The procedure is performed with local anaesthetic and sedation. A short and thin plastic tube (cannula) will be placed into a vein in your arm.
Please let Dr Zertalis know about any medications you take, any allergies you may have and if you previously have had a reaction to the x-ray dye (contrast).
You will be asked to change into a hospital gown and lie on your back, front or side in the position that Dr Zertalis has decided is most suitable. You will have devices attached to your chest, arm and finger to monitor you pulse, blood pressure and oxygen levels. You will be given a sedative to relieve anxiety and painkillers where necessary. This is standard for all minimally invasive interventional radiology procedures performed in Cyprus.
The procedure is performed under sterile conditions and Dr Zertalis will wear sterile gowns and gloves. Your skin will be swabbed with antiseptic and you will be covered with sterile drapes.
Your skin near the point of insertion will be numbed using local anaesthetic. When the local anaesthetic is injected you will likely experience a burning sensation for 30 to 60 seconds.
Dr Zertalis will use ultrasound (US) and X-Rays (Fluoroscopy), to navigate a fine needle into the gallbladder followed by the insertion of a guide wire over which a drainage tube is inserted and positioned into the fluid collection. This will be connected to a drainage bag.
Every patient is different, however, expect to be in the radiology department for up to 1 hour.
After the procedure
You will be transferred to your ward where your pulse, blood pressure, oxygen levels and the entry site in the skin will be checked by our team at regular intervals. You should expect to be in bed for up to 6 hours until you have recovered. You should expect relief of symptoms within a few hours. The drain will remain in the gallbladder for a minimum of two weeks. Dr Zertalis will discuss this with you in detail.