Safety and feasibility of percutaneous ultrasound guided puncture of the gall-bladder for crystal analysis.
The safety and feasibility of ultrasound guided percutaneous aspiration (USPA) of bile, for bile crystal analysis was assessed critically. Forty-four patients about to undergo elective cholecystectomy underwent intended transhepatic USPA 1 h before their operation. At laparotomy a careful inspection for bile and blood leakage was made and a further sample of gall-bladder bile collected. Successful USPA occurred in 40 of the 44 patients. The four unsuccessful cases each had a gall-bladder packed with stones and contained virtually no bile. Three patients developed bile leak after transperitoneal (n = 2) and transhepatic (n = 1) puncture of the gall-bladder and another patient lost 100 mL of blood. Microscopic analysis of paired bile samples confirmed that gall-bladder bile (as opposed to hepatic bile) had always been aspirated. Ultrasound guided percutaneous aspiration of bile offers a simple and promising alternative to duodenal intubation, but considerable experience is required before it can be recommended as its replacement.
Hosking
S W
SW
Department of Surgery, Southampton General Hospital, England.
Hacking
C N
CN
Herbetko
J
J
Dewbury
K C
KC
D001707:Biopsy, Needle / Q000379:methods*; D002137:Calculi / Q000000981:diagnostic imaging / Q000473:pathology*; D005240:Feasibility Studies; D005704:Gallbladder / Q000000981:diagnostic imaging / Q000473:pathology*; D005705:Gallbladder Diseases / Q000000981:diagnostic imaging / Q000473:pathology*; D006801:Humans; D012449:Safety; D014463:Ultrasonography