Simple gallbladder puncture as a diagnostic tool and therapy in critically ill patients with presumed acute cholecystitis

In 15 out of 16 critically ill patients, bedside percutaneous sonographically guided transhepatic aspiration of the gallbladder contents established the diagnosis of acute cholecystitis. During the same procedure, the contents of the gallbladder were thoroughly aspirated, the gallbladder rinsed with saline and local antibiotics administered. No complications of the procedure were observed. In one patient a second and third procedure were performed because of a pericholecystic abscess. In no patients were permanent catheters used for drainage. Fourteen patients recovered completely from their acute cholecystitis. Death of one patient was not related to the puncture procedure. No further surgery or treatments were needed.