From the Guidelines
Percutaneous cholecystostomy (perc chole) drainage bags should be changed every 4-6 weeks, with the exact timing dependent on individual patient factors, such as the presence of diabetes, ascites, long-term steroid therapy, and malnutrition, which may require a longer duration of drainage 1. When considering the management of perc chole bags, it is essential to prioritize the prevention of complications, such as bile leakage and infection, while also ensuring the proper functioning of the drainage system.
- The duration of drainage typically ranges from 3 to 6 weeks, with an average of 1 month, allowing for the maturation of the tract and reducing the risk of bile leak 1.
- A cholangiography via the drain is recommended before drain withdrawal to ensure the absence of leak or obstructed cystic duct, which can help prevent potential symptoms recurrence 1.
- Patients can be discharged home with the drain in place, and regular monitoring of the drainage output and catheter site is crucial to identify any signs of complications, such as leakage, decreased drainage output, cloudy or foul-smelling bile, increased pain, or damage to the bag.
- The procedure for changing the bag involves careful sterile technique to avoid introducing bacteria into the biliary system, and patients should be instructed on how to empty the drainage bag regularly and keep the insertion site clean and dry.
- It is also important to note that the evidence for the use of a cholecystocholangiography in the elderly population is low, and therefore, the decision to perform this procedure should be made on a case-by-case basis, taking into account the individual patient's risk factors and medical history 1.
From the Research
Perc Chole Bags Change Frequency
- The provided studies do not directly address the frequency of changing perc chole bags, but they do discuss the management and removal of percutaneous cholecystostomy tubes 2, 3, 4, 5, 6.
- According to a study published in 2016, the timing of percutaneous cholecystostomy tube removal is argued, and the ideal timing is not well established 5.
- A systematic review performed in 2016 found that the timing of tube removal varied from 2 to 193 days, and regression analyses showed no correlation between length of tube maintenance and morbidity, mortality, and disease recurrence 5.
- Another study published in 2005 found that the incidence of bile leaks upon removal of small-bore percutaneous cholecystostomy catheters was low, and that clinical and imaging guidelines can help ensure safe catheter removal 6.
- The studies suggest that the management of percutaneous cholecystostomy tubes, including the frequency of changing perc chole bags, should be individualized based on patient factors and clinical guidelines 2, 3, 4, 5, 6.
Key Findings
- Percutaneous cholecystostomy is an effective procedure for treating acute cholecystitis in high-risk patients 2, 3, 4.
- The procedure can be used as a definitive treatment or as a bridge to surgery 2, 3.
- The timing of tube removal is not well established, but clinical and imaging guidelines can help ensure safe catheter removal 5, 6.
- The incidence of bile leaks upon removal of small-bore percutaneous cholecystostomy catheters is low 6.
Clinical Implications
- Clinicians should individualize the management of percutaneous cholecystostomy tubes based on patient factors and clinical guidelines 2, 3, 4, 5, 6.
- The frequency of changing perc chole bags should be determined based on clinical judgment and patient needs 5, 6.
- Further research is needed to establish evidence-based guidelines for the management of percutaneous cholecystostomy tubes, including the frequency of changing perc chole bags 5.