The gallbladder is a small sac-like structure under the liver, which stores bile salts that are secreted into the intestines during eating to aid in fat digestion. If the gallbladder ever becomes obstructed or infected, it is an emergency that must be rapidly treated with antibiotics and surgical removal, if necessary. 

When surgery is not an option due to the severity of illness of the patient or due to patient and family preference, interventional radiologist can place a plastic tube into the gallbladder through the skin, which allows drainage of an obstruction of infected fluid, this procedure is call cholecystosomy. Your family will receive significant education on the skin care surrounding the tube as well proper maintenance of the tube and extension material.

About this Treatment

About this Treatment

How do we perform a cholecystostomy?

Using ultrasound and live X-ray (fluoroscopy) for guidance, the radiologist will insert a small needle through the skin and into the gallbladder, followed by placement of the catheter into the gallbladder. The catheter will be connected to a drainage bag or bulb, which will be located outside of the body in the right upper abdomen. Your child will be protected by an X-ray shield during the procedure.

Will my child be awake for the procedure?

No. We will use either intravenous sedation or general anesthesia so that your child isn’t awake.

Will my child be in any pain?

Your child will not feel pain during the procedure but some patients may feel discomfort around the tube insertion site for a few days following the procedure. This can be treated by over-the-counter pain medications.

How long does the procedure take?

A typical cholecystostomy tube insertion takes about an hour but may take longer. Some children may need to arrive many hours before the procedure to have certain lab tests performed, which will be clearly communicated to you.

What risks are associated with the procedure?

The procedure is considered low-risk. However, potential complications include:

  • Bleeding
  • Tenderness of soreness at the site where the tube is placed
  • Infection
  • Injury to the gallbladder
  • Bile leak (biloma)
  • Puncture of the lung (very rare)
  • Allergic reaction to X-ray dye (contrast reaction)
  • Right shoulder pain (radiating from the liver)
  • Clogging of the tube
  • Loss of access into the stoma (skin opening over the gallbladder
Pre and Post Operative Care

Pre and Post Operative Care

How do my child and I prepare for the procedure?

We encourage good communication between you and your child, including the necessity and overview of the procedure as well as ensuring them that you are close by the whole time. Holding them or their hands until they leave for the procedure is a great way to provide support.

You will be given specific instructions along the way but you may need to arrive a few hours before the scheduled procedure to have some blood tests done. When you arrive at the hospital, a doctor will review the procedure and associated risks, after which you will sign a consent form. When we are ready to get started with the procedure, a nurse will place an intravenous line to deliver sedating medications and you will be allowed to accompany your child in the operating room until they are asleep, after which you will be escorted to a waiting room.

What happens after the procedure?

Nurses will monitor your child in the recovery area for a couple hours for successful recovery from any sedating medications, if any, and any immediate complications. The doctor may decide to have your child admitted to the hospital for an overnight stay. As mentioned, there may be some discomfort around the tube insertion site for some days following the procedure, which is easily relieved by over-the-counter medications.

When can my child bathe?

You can allow your child to sponge bathe after the procedure. It is important to avoid full submersion in water as the gauze and bandage surrounding the skin must remain dry at all times. The catheter will also be secured with a locking device called a “StatLock,” which must not be removed.

Are there any activity restrictions?

Though your child can resume normal school-going or daycare attendance, physical activity that can result in pulling of the tube should be limited, particularly contact sports and rough playing.

How long will the tube stay in place?

The total duration of tube placement will be determined by the physician caring for your child’s underlying disease. Specific concerns regarding clogging of the tube or the tube falling out will be addressed in your training prior to the procedure. These are not true emergencies and can most often be handled by simple water flushing of the tube through a syringe or slightly pushing the tube back into place and securing it with tape. It is important to call our department soon after these occurrences. 


• Redness, pain, swelling, or bruising at the needle insertion site.• Fever higher than 101o Fahrenheit or 38o Celsius.

The department of Interventional Radiology can be reached at: 202-476-3791, Monday through Friday, between 8 a.m. and 5 p.m.

At all other times please call 202-259-8643, which is the on-call pager. Follow the instructions and wait for a call back.

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