Ultrasound-guided percutaneous transhepatic cholecystic puncture and drainage for acute severe cholecystitis—a Case Report

BackgroundPatients with multiple underlying diseases, older patients, or those with temporary contraindications to surgery should not undergo laparoscopic cholecystectomy for the time being. Instead, percutaneous transhepatic cholecystic puncture and drainage with tube placement is the preferred opt...

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Main Authors: Liqiang Li, Yunfei Zhang, Zihan Zeng, Liang Li, Jun Zhang
Format: Article
Language:English
Published: Frontiers Media S.A. 2025-07-01
Series:Frontiers in Medicine
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Online Access:https://www.frontiersin.org/articles/10.3389/fmed.2025.1585967/full
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author Liqiang Li
Liqiang Li
Yunfei Zhang
Yunfei Zhang
Zihan Zeng
Zihan Zeng
Liang Li
Liang Li
Jun Zhang
Jun Zhang
author_facet Liqiang Li
Liqiang Li
Yunfei Zhang
Yunfei Zhang
Zihan Zeng
Zihan Zeng
Liang Li
Liang Li
Jun Zhang
Jun Zhang
author_sort Liqiang Li
collection DOAJ
description BackgroundPatients with multiple underlying diseases, older patients, or those with temporary contraindications to surgery should not undergo laparoscopic cholecystectomy for the time being. Instead, percutaneous transhepatic cholecystic puncture and drainage with tube placement is the preferred option.Patient summaryA 55-year-old patient was admitted to the hospital due to “sudden upper abdominal pain and discomfort lasting for more than 1 day.” The issue began with epigastric pain and discomfort after consuming greasy food, leading to persistent bloating accompanied by nausea and vomiting of gastric contents. There were no chills or fever present. The patient initially sought treatment at the local county hospital, but symptomatic treatments there proved ineffective. Consequently, the patient and their family visited a local municipal tertiary hospital in an emergency. At the municipal hospital, it was recommended that the patient undergo a “laparoscopic cholecystectomy.” However, since the patient had undergone coronary stent implantation at the local county hospital on November 5, 2024, surgery was considered contraindicated. With acute severe cholecystitis symptoms worsening and pain relief efforts proving inadequate, the patient and family sought further treatment. After preoperative evaluations, the patient underwent a successful percutaneous transhepatic cholecystic puncture and drainage guided by color ultrasound. This procedure resulted in significant improvement in both abdominal pain and inflammatory markers.ConclusionFor patients undergoing surgical cardiac stent implantation, requiring prolonged anticoagulant therapy, and concurrently experiencing acute severe cholecystitis, percutaneous transhepatic gallbladder drainage (PTGD) is an effective treatment option.
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spelling doaj-art-21a336ca31f74e2dbca43a5e28f0b7cf2025-08-20T03:31:11ZengFrontiers Media S.A.Frontiers in Medicine2296-858X2025-07-011210.3389/fmed.2025.15859671585967Ultrasound-guided percutaneous transhepatic cholecystic puncture and drainage for acute severe cholecystitis—a Case ReportLiqiang Li0Liqiang Li1Yunfei Zhang2Yunfei Zhang3Zihan Zeng4Zihan Zeng5Liang Li6Liang Li7Jun Zhang8Jun Zhang9Department of General Surgery, The Second People’s Hospital of Hefei, Hefei Hospital Affiliated to Anhui Medical University, Hefei, ChinaDepartment of General Surgery, Hefei Second People’s Hospital Affiliated to Bengbu Medical University, Bengbu, ChinaDepartment of General Surgery, The Second People’s Hospital of Hefei, Hefei Hospital Affiliated to Anhui Medical University, Hefei, ChinaDepartment of General Surgery, Hefei Second People’s Hospital Affiliated to Bengbu Medical University, Bengbu, ChinaDepartment of General Surgery, The Second People’s Hospital of Hefei, Hefei Hospital Affiliated to Anhui Medical University, Hefei, ChinaDepartment of General Surgery, Hefei Second People’s Hospital Affiliated to Bengbu Medical University, Bengbu, ChinaDepartment of General Surgery, The Second People’s Hospital of Hefei, Hefei Hospital Affiliated to Anhui Medical University, Hefei, ChinaDepartment of General Surgery, Hefei Second People’s Hospital Affiliated to Bengbu Medical University, Bengbu, ChinaDepartment of General Surgery, The Second People’s Hospital of Hefei, Hefei Hospital Affiliated to Anhui Medical University, Hefei, ChinaDepartment of General Surgery, Hefei Second People’s Hospital Affiliated to Bengbu Medical University, Bengbu, ChinaBackgroundPatients with multiple underlying diseases, older patients, or those with temporary contraindications to surgery should not undergo laparoscopic cholecystectomy for the time being. Instead, percutaneous transhepatic cholecystic puncture and drainage with tube placement is the preferred option.Patient summaryA 55-year-old patient was admitted to the hospital due to “sudden upper abdominal pain and discomfort lasting for more than 1 day.” The issue began with epigastric pain and discomfort after consuming greasy food, leading to persistent bloating accompanied by nausea and vomiting of gastric contents. There were no chills or fever present. The patient initially sought treatment at the local county hospital, but symptomatic treatments there proved ineffective. Consequently, the patient and their family visited a local municipal tertiary hospital in an emergency. At the municipal hospital, it was recommended that the patient undergo a “laparoscopic cholecystectomy.” However, since the patient had undergone coronary stent implantation at the local county hospital on November 5, 2024, surgery was considered contraindicated. With acute severe cholecystitis symptoms worsening and pain relief efforts proving inadequate, the patient and family sought further treatment. After preoperative evaluations, the patient underwent a successful percutaneous transhepatic cholecystic puncture and drainage guided by color ultrasound. This procedure resulted in significant improvement in both abdominal pain and inflammatory markers.ConclusionFor patients undergoing surgical cardiac stent implantation, requiring prolonged anticoagulant therapy, and concurrently experiencing acute severe cholecystitis, percutaneous transhepatic gallbladder drainage (PTGD) is an effective treatment option.https://www.frontiersin.org/articles/10.3389/fmed.2025.1585967/fullcontraindications to surgerycholecystocentesis and drainageultrasound guidanceacute severe cholecystitisgallbladder stones
spellingShingle Liqiang Li
Liqiang Li
Yunfei Zhang
Yunfei Zhang
Zihan Zeng
Zihan Zeng
Liang Li
Liang Li
Jun Zhang
Jun Zhang
Ultrasound-guided percutaneous transhepatic cholecystic puncture and drainage for acute severe cholecystitis—a Case Report
Frontiers in Medicine
contraindications to surgery
cholecystocentesis and drainage
ultrasound guidance
acute severe cholecystitis
gallbladder stones
title Ultrasound-guided percutaneous transhepatic cholecystic puncture and drainage for acute severe cholecystitis—a Case Report
title_full Ultrasound-guided percutaneous transhepatic cholecystic puncture and drainage for acute severe cholecystitis—a Case Report
title_fullStr Ultrasound-guided percutaneous transhepatic cholecystic puncture and drainage for acute severe cholecystitis—a Case Report
title_full_unstemmed Ultrasound-guided percutaneous transhepatic cholecystic puncture and drainage for acute severe cholecystitis—a Case Report
title_short Ultrasound-guided percutaneous transhepatic cholecystic puncture and drainage for acute severe cholecystitis—a Case Report
title_sort ultrasound guided percutaneous transhepatic cholecystic puncture and drainage for acute severe cholecystitis a case report
topic contraindications to surgery
cholecystocentesis and drainage
ultrasound guidance
acute severe cholecystitis
gallbladder stones
url https://www.frontiersin.org/articles/10.3389/fmed.2025.1585967/full
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