When your gallbladder is blocked and you’re unable to release bile, your gallbladder is at risk of getting infected or swollen. This causes cholecystitis and oftentimes calls for a cholecystostomy if gallbladder removal surgery isn’t safe. What is a cholecystostomy? Read on to learn all about it.
Cholecystostomy Procedure
A cholecystostomy procedure is a minimally invasive procedure that will allow infected fluid from your gallbladder to drain, help get rid of infection, and possibly increase your chances of having a safe surgery down the road.
You will receive an IV that will provide your body fluids and antibiotics. You might also receive a sedative via IV, as cholecystostomies are usually done under conscious sedation. You’ll feel very relaxed for an hour or so but will be conscious while the procedure is performed.
Your healthcare provider will use ultrasound and a live X-ray to find the best spot to insert the catheter. They’ll mark the spot, clean it, and cover the rest of your body in sterile drapes to minimize risk of infection. Your healthcare provider and anyone assisting them will also wear sterile materials and masks. After the area is prepared, you’ll receive a numbing injection.
Your healthcare provider will guide a tiny needle through your skin and into your gallbladder. After removing the needle, they’ll place a small catheter into your gallbladder. Your catheter will connect to a bag or bulb outside the body to hold the drainage. The entry site will be covered and kept clean with gauze and a clear bandage, and the catheter will be held secure with a locking device. You could have a catheter for a few days, a few weeks, or longer.
You’ll be lying flat on your back during the procedure, and you shouldn’t feel any pain or discomfort. It will likely be done by an interventional radiologist, an expert in minimally invasive procedures like cholecystostomies.
Do You Need a Cholecystostomy?
If you have an infected gallbladder or are sick and are not a candidate for gallbladder removal, you’ll probably need a cholecystostomy. If you’re too sick or can’t have anesthesia, you’re not a likely candidate for gallbladder removal. Other than signs of gallbladder infection, there are no real cholecystostomy indications.
Complications of a Cholecystostomy
Typically, a cholecystostomy is very safe. Although it’s minimally invasive, it’s still invasive. You’re at risk for bleeding, damage to surrounding structures, infection, and bile leaks. Discuss cholecystostomy complications with your healthcare provider to make sure you fully understand possible outcomes of the procedure.
Preparing for a Cholecystostomy
Getting ready for this kind of procedure is straightforward. Preparation for a cholecystostomy can include:
- Telling your healthcare provider if you take a blood thinner every day. You’ll need to stop taking it before the procedure, and you’ll probably need updated lab tests done on the day of your cholecystostomy.
- Don’t eat anything for six hours before your procedure. Let your healthcare provider know if you take daily medications. You might be able to take them on the morning of your cholecystostomy with some water.
- Plan on being in the hospital for 24 hours or so. You’ll be watched closely, and your healthcare provider will decide when to discharge you.
- Alert your healthcare provider to any allergies that might be relevant. This could include latex, iodine, anesthesia, antibiotics, contrast dyes, or any other kind of medication.
- Let your healthcare provider know if you’re pregnant or think you might be pregnant.
After a Cholecystostomy
Once the procedure is done, you’ll go to a hospital room, and a nurse will monitor you while you recover from the anesthesia. Your nurse will keep an eye on how much bile drains through your catheter and what color the bile is. If you feel nauseated, feverish, chilly, or uncomfortable where the tube was inserted, tell your nurse. Before you go home, your nurse will show you how to care for your tube, including how to flush a solution through the drain, something you’ll have to do each day to keep the tube from getting clogged.
Once you go home, you’ll need to take great care of the drainage tube and bag. Your healthcare provider will give you detailed instructions that may include:
- Changing your dressing every three days or more often if needed
- Cleaning the tube entry site with soap and water
- Flushing your drain every day
- How often to visit your healthcare provider to have your tube and bag changed
- Emptying and measuring drainage every day
You might feel a little pain at the entry site for a day or two after the procedure. Try over-the-counter pain medication if the pain lasts a little longer, and don’t hesitate to get in touch with your healthcare provider if the pain is intense or won’t go away. Avoid any activities that could result in your tube accidentally being pulled out!
When to Call Your Healthcare Provider
As you recover from your cholecystostomy, pay attention to how your body feels. If you feel like your recovery isn’t going as it should, reach out to your healthcare provider. It’s better to be safe than sorry! Warning signs of poor recovery can include:
- Redness at the entry site
- Smelly drainage around the entry site
- Swelling at the entry site
- A fever higher than 100.4°F
- Pain at the entry site or on the side of your abdomen where the entry site is that doesn’t go away with pain medication
- Broken stitches at the entry site
- A tube that is loose or falls out
- Having to change your dressing more than one or two times a day
- Not being able to flush your drain
- A tube that becomes clogged
If you’re experiencing one or more of these symptoms, you should call your healthcare provider immediately.
