What Are MIIPs?Infected Gallbladder


What is a Cholecystostomy Tube?

A cholecystostomy tube (C-tube) is used to drain an infected gallbladder through the skin. A C-tube is different than a “cholecystectomy,” which is surgery to remove the gallbladder. What is the gallbladder?

The gallbladder sits next to the liver in the right upper abdomen. It is a little bag that stores bile. Bile is the yellow-green juice that the liver makes to help digest food. When you eat, the gallbladder squirts bile through a little duct and into the gut.



Why do I need a C-tube?

Some people have gallstones inside their gallbladder. Gallstones are abnormal, solid “stones” that can form inside the gallbladder. Gallstones can cause no symptoms or they can cause pain with eating. Sometimes gallstones can block the gallbladder duct and cause infection. When the gallbladder is infected, it is called “cholecystitis.” People who are very sick can also develop cholecystitis, even if they don’t have gallstones.

Most people who have cholecystitis need surgery to remove the gallbladder. Some people with cholecystitis cannot have surgery because they are too sick or they cannot have anesthesia. A C-tube can drain the infected bile in people who cannot have surgery.

If your doctors say that you cannot safely have surgery at this time, they may recommend a C- tube to drain the gallbladder and let it heal. Later on, if you are well enough for surgery, a surgeon may remove your gallbladder.



Who places C-tubes?

C- tubes are placed by called Interventional Radiologists (IRs), who are experts in minimally invasive, image-guided procedures (MIIPs). They place the C-tube through a small hole in the skin, using medical pictures to see inside the body.



How is a C-tube placed?

You will lay flat on your back. Your right upper abdomen will be cleaned and prepared. You will get medicine to make you drowsy and comfortable. The IR will use ultrasound or a CT scan to see your gallbladder. Your IR doctor will numb your skin so that you do not feel pain. The IR will then place the C-tube into the gallbladder through a small nick in the skin. The bile will start draining through the C-tube into a bag that hangs at your side. The C-tube will be secured

to your skin with a stitch or special dressing. The C-tube has a pigtail at the end to help it stay in place. However, avoid yanking on it, as you can break the pigtail and accidentally pull it out.



What happens after the C-tube is placed?

C-tubes are usually placed in patients while they are in the hospital. Most people will go home with the C-tube. You will need your C-tube for 6 weeks or until you can have surgery to remove your gallbladder. The C-tube needs to stay in place while the gallbladder is still blocked or else the infection will recur. Also, taking the C-tube out before 6 weeks can result in a bile leak, which can make you very sick. If you are not able to have surgery to remove the gallbladder, then your C-tube will need to be exchanged regularly by your IR.

You may be instructed to flush the C-tube with sterile water to keep it from clogging up. If so, your nurse will show you how to do this properly. Your nurse will also show you how to empty the bag.

A C-tube that is clogged or gets pulled out partially or completely needs to be replaced. Call your IR if:

  • it becomes harder to flush your C-tube
  • the C-tube is draining less
  • you are starting to feel sick again (abdominal pain, nausea, fever)



What are the risks of a C-tube placement?

Placement of a C-tube is usually very safe. Potential risks are bleeding, infection, damage to surrounding structures, and bile leak. You will be monitored closely for possible complications.



For more information on cholecystostomy tubes:

http://www.radiologyinfo.org/en/info.cfm?pg=cholecystitis

http://www.sw.org/HealthLibrary?page=Cholecystostomy



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