Application of trocar technique in ultrasound-guided drainage of the gallbladder.
OBJECTIVE
The ultrasound-guided drainage of the gallbladder (USDGB) is mainly performed by Seldinger technique. We aim to evaluate the use of the easier performable trocar technique in draining critically ill patients with acute calculous or acalculous cholecystitis.


METHODS
Critically ill patients with acute acalculous (AAC; n=29) or calculous cholecystitis (ACC; n=7) underwent trocar technique application of USD. Technical problems, complications and patients' further courses were recorded.


RESULTS
In group 1 (AAC) 29/29 patients could be drained without problems or complications. Three dislocations of the USDGB were seen. In group 2 (CAC) only four out of seven could be drained by this technique, in these four patients (a) major bleeding and (b) pericholecystic fluid collections were observed. In both groups no further complications during USDGB or its removal were seen.


CONCLUSIONS
In acute acalculous cholecystitis the use of trocar technique in applying the USDGB is easy and bedside performable, in acute calculous cholecystitis the USD should be done by Seldinger technique.
Federmann
G
G
Chirurgische Klinik, SHG-Kliniken Völklingen, Richardstr. 5-9, D-66333, Völklingen, Germany. g.federmann@t-online.de
Walenzyk
J
J
D000208:Acute Disease; D002764:Cholecystitis / Q000000981:diagnostic imaging / Q000628:therapy; D002769:Cholelithiasis / Q000000981:diagnostic imaging / Q000628:therapy; D016638:Critical Illness; D004322:Drainage / Q000295:instrumentation / Q000379:methods*; D005704:Gallbladder / Q000000981:diagnostic imaging*; D006801:Humans; D013525:Surgical Instruments; D018084:Ultrasonography, Interventional / Q000295:instrumentation / Q000379:methods*