From February 1, 1989, to February 1, 1990, 21 patients with gallbladder disease were treated with percutaneous methods according to two algorithms we devised. Twelve patients had a nonfunctioning gallbladder prior to treatment. Only one of these had an afunctional gallbladder at the conclusion of the treatment, and a chemical cholecystectomy was performed in this case. Five older patients underwent dissolution of cholesterol stones with methyl tert-butyl ether after previous percutaneous drainage of an empyema or hydrops. In the 16 other patients, percutaneous cholecystolithotomy was performed. Altogether, 18 of the 21 patients were successfully treated. Three patients had to undergo cholecystectomy because of technical infeasibility (two cases) or delayed bile leak (one case). There were no deaths and no wound infections. Percutaneous treatment of gallbladder disease seems attractive because of the absence of a significant scar, the possible physiologic importance of leaving the gallbladder in place, and the increasing ease of dealing with possible recurrences thanks to improved diagnostic imaging and an array of minimally invasive treatment techniques.
