Percutaneous ultrasound-guided cholecystocentesis: complications and association of ultrasonographic findings with bile culture results.

Abstract

To retrospectively evaluate cases presented for percutaneous ultrasound-guided cholecystocentesis for associated complications, identify risk factors associated with complications and to assess ultrasonographic findings and relate these to bacterial culture results. Data on 300 patients presented for percutaneous ultrasound-guided cholecystocentesis were retrospectively collected and ultrasonographic images were assessed for defined structural changes. The incidence of major complications was determined. Multi-variable multi-level logistic regression was used to investigate the association of ultrasonographic findings with positive bile culture. Three hundred percutaneous ultrasound-guided cholecystocentesis procedures performed in 201 dogs and 51 cats were included; 35 patients had the procedure performed more than once. The overall incidence of major complications was 8 of 300 procedures (2·7%). Bile peritonitis occurred in 2 of 300 procedures (0·7%). An ultrasonographically abnormal gall bladder was found in 52% of cases and had a sensitivity, specificity and accuracy of 82, 55·7 and 61·5% respectively, to predict a positive bile culture. Percutaneous ultrasound-guided cholecystocentesis is overall a safe technique when carried out in selected patients. Abnormal ultrasonographic findings are only a fair predictor of a positive bile culture.