BackTable / VI / Podcast / Episode #185
with Dr. Christopher Beck
Co-hosts Dr. Christopher Beck and Dr. Aaron Fritts discuss cholecystostomy tube placement for acute cholecystitis, including the pros and cons of different techniques, and pitfalls to avoid.
BackTable, LLC (Producer). (2022, February 7). Ep. 185 – Cholecystostomy Tubes [Audio podcast]. Retrieved from https://www.backtable.com
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Dr. Christopher Beck
Dr. Chris Beck is a practicing interventional radiologist with Regional Radiology Group in New Orleans.
Dr. Aaron Fritts
Dr. Aaron Fritts is a Co-Founder of BackTable and a practicing interventional radiologist in Dallas, Texas.
In this episode, our hosts Dr. Aaron Fritts and Dr. Chris Beck compare their procedural techniques for placing cholecystostomy tubes.
They start the conversation by discussing patient workup. Dr. Beck always obtains an ultrasound and sometimes a HIDA scan. He also orders coagulation tests and checks if the patient is on anticoagulation medication in order to stratify the risk of the procedure and counsel the patient accordingly.
Next, the doctors discuss pros and cons of transhepatic and transperitoneal approaches. Dr. Fritts usually prefers a transhepatic approach because it minimizes the risk of biliary leaks. He also believes that it is easier to stick the gallbladder in an area where it is affixed to the liver.
Dr. Beck emphasizes that the gallbladder is a dynamic organ, so doing this procedure under ultrasound with fluoroscopy will allow real-time visualization of the needle.
Finally, they consider different needle and drainage options. There are a variety of needles that can be used, including AccuStick, Yueh, and spinal needles. With drainage, the doctors highlight the differences between drainage bags and JP bulbs, noting that the former relies on drainage of infected bile by gravity, and the latter provides additional vacuum suction.
Disclaimer: The Materials available on BackTable.com are for informational and educational purposes only and are not a substitute for the professional judgment of a healthcare professional in diagnosing and treating patients. The opinions expressed by participants of the BackTable Podcast belong solely to the participants, and do not necessarily reflect the views of BackTable.