66.18 Injuries of the gall bladder

If only the fundus of the gall bladder is injured, do a cholerystostomy (13.3). With severe injuries the best treatment is usually cholecystectomy, which is difficult (13.6). You can do a cholerystostomy with a de Pezzei catheter in much the same way as a caecostomy.

CHOLECYSTOSTOMY Put a de Pezzer catheter into the patient’s gall bladder as in Figs. 13-1 and 66-18. Anchor it to his abdominal wall in a similar way. If you find any stones in his gall bladder, remove as may as you can, before closing the purse string suture round the tube. A temporary biliary fistula will form, and then slowly heal.