Percutaneous cholecystocholedochostomy for cholecystitis and cystic duct obstruction in gallbladder carcinoma.
Percutaneous cholecystocholedochostomy was performed in a patient with acute cholecystitis caused by cystic duct obstruction by gallbladder carcinoma, but removal of the percutaneous cholecystostomy catheter was unsuccessful because of continuing discharge. After creation of a cholecystocholedochostomy through the cholecystostomy tract with use of a transjugular liver access set and a 21-gauge needle, self-expandable metallic stents were placed in the narrowed common bile duct and the newly created tract between the gallbladder and the common hepatic duct. The external cholecystostomy catheter was successfully removed after the procedure. Jaundice occurred 70 days later as a result of tumor invasion above the segment with the stent, and an additional stent was placed. The patient died of diffuse metastasis 143 days after creation of the cholecystocholedochostomy without recurrence of cholecystitis.
Miyayama
Shiro
S
Department of Diagnostic Radiology,Fukuiken Saiseikai Hospital, 7-1, Funabashi, Wadanaka-cho, Fukui 918-8503, Japan. s-miyayama@fukui.saisekai.or.jp
Matsui
Osamu
O
Akakura
Yukari
Y
Yamamoto
Toru
T
Nishida
Hiroto
H
Minami
Tetsuya
T
Kozaka
Kazuto
K
Tawaraya
Kanae
K
Kasahara
Yoshio
Y
D000230:Adenocarcinoma / Q000150:complications*; D000368:Aged; D002764:Cholecystitis / Q000209:etiology / Q000601:surgery*; D002767:Cholecystostomy / Q000379:methods*; D002768:Choledochostomy / Q000379:methods; D001651:Cholestasis, Extrahepatic / Q000209:etiology / Q000601:surgery*; D003549:Cystic Duct; D005706:Gallbladder Neoplasms / Q000150:complications*; D006801:Humans; D008297:Male; D015607:Stents