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

Abstract

OBJECTIVES: 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. METHODS: 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. RESULTS: 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. CLINICAL SIGNIFICANCE: 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.