Radiology, Vol 178, 687-689, Copyright © 1991 by Radiological Society of North America
Gallbladder perforation and bile leakage: percutaneous treatment
E vanSonnenberg, HB D'Agostino, G Casola, DB Hoyt, A Lurie and RR Varney
Department of Radiology, University of California, San Diego 92103.
Three patients with spontaneous gallbladder perforation and one with an
iatrogenic bile leak causing bile peritonitis were treated successfully by
means of percutaneous catheter drainage. Three patients had cholelithiasis
as the cause of perforation; the fourth patient had previously undergone
gallstone dissolution with methyl tert-butyl ether lavage and developed
bile peritonitis a few hours after removal of the catheter. In three
patients, a percutaneous cholecystostomy catheter provided successful
decompression; in the fourth patient, drainage was performed with a
percutaneous sump catheter in the subhepatic space adjacent to the
gallbladder. No specific complications occurred. Follow- up was performed
at 1, 12, 22, and 59 months, respectively. To date, one of the four
patients has undergone elective cholecystectomy (1 month after drainage).
The remainder of the patients are asymptomatic. This preliminary experience
suggests that the severe complication of gallbladder perforation and bile
leakage may be treated, at least temporarily, by means of percutaneous
drainage.
