SIR 2024
Pediatric Interventions
S Murthy CHENNAPRAGADA, FRANZCR (he/him/his)
Staff Paediatric Interventional Radiologist
The Children's Hospital at Westmead, Australia
Disclosure information not submitted.
David Lord, FRANZCR
Paediatric interventional radiologist
The Children's Hospital at Westmead, Australia
Disclosure information not submitted.
Bapesh Bollu, MBBS
Surgical Registrar
The Children's Hospital at Westmead, Australia
Disclosure information not submitted.
Gordon Thomas, MBBS, MS
Paediatric Surgeon
Department of Surgery, The Children's Hospital at Westmead, Australia
Disclosure information not submitted.
Percutaneous Cholecystostomy (PC) is a well-established procedure, for non-surgical management of acute cholecystitis in the adult population. However its use in the paediatric population is not widely described. Our primary aim was to report our institutional experience with indications, technical success and clinical outcomes for PC in children.
Materials and methods:
Retrospective review was done of electronic medical records of all children that were referred to Interventional radiology for percutaneous cholecystostomy between January 2010 and June 2020. Demographic data, clinical indications, technical details of the procedure, complications, post procedural clinical course including drain dwell-in time and any additional procedures performed were recorded.
Results:
20 children (M:F::12:8) aged 2 month - 13y (median 4 months) had PC placed. Primary indication was biliary obstruction (18/20) the most common cause being inspissated biliary sludge syndrome; 2 /17(11%) underwent PC for acalculous cholecystitis.
All procedures were done under GA and under imaging guidance. Technical success was 95%. Drain dwell-in periods ranged between 1-18 weeks (median 4weeks).
2 patients required re-intervention to upsize the biliary drain.
5 patients went on to have a more definitive operative procedure. There were no major complications; three minor complications were noted: drain malposition, drain dislodgement and a bile leak.
Conclusion:
Based on our experience, percutaneous cholecystostomy is a safe and effective minimally invasive procedure in children. In this cohort, PCÂ was more commonly used for relief of bilairy obstruction. In a significant number of these patients PC served as a bridge to a definitive surgical procedure.