laparoscopic cholecystostomy tube placement cpt codelaparoscopic cholecystostomy tube placement cpt code
CPT guidelines instruct us to code separately for each catheter placement, replacement, conversion, or removal. Authors Joseph T Church 1 , Daniel H Teitelbaum, Marcus D Jarboe. #2. if you have Dr. Z's interventional book, it tells you to use abcess codes 49424,76080,49423 & 75984 for tube check and change of cholecystostomy tube if the the tube was originally placed for infection drainage. 530.3 Stricture and stenosis of esophagus (ICD 9) ICD-10 Code K22.3 Perforation of Esophagus. Given the success with this operative approach, laparoscopic cholecystectomy is considered the gold standard for the surgical treatment of gallstone disease. Patient subsequently underwent interval cholecystectomy, when the inflammation had subsided. Agastrostomy tube, or G-tube, is atube inserted through the abdomen to deliver nutrition directly into the stomach. A cholecystostomy or cholecystotomy is a procedure where a stoma is created in the gallbladder, which can facilitate placement of a tube for drainage, first performed by American surgeon, Dr. John Stough Bobbs, in 1867. Epub 2006 Feb 27. The Gallbladder was necroticthe cystic duct and commom duct junction were extremelt scarred and fibrotic. Three patients (20%) were admitted to the intensive care unit. 47562 Laparoscopy, surgical; cholecystectomy Average fee amount $600 $750, 47563 Laparoscopy, surgical; cholecystectomy with cholangiography, 47564 Laparoscopy, surgical; cholecystectomy with exploration of common duct Average fee amount- $1050 $1200. 47536 describes the exchange of an existing external biliary drainage catheter/external biliary drainage catheter or exchange of an existing internal/external catheter for a lesser external catheter, and includes diagnostic imaging. A new internal/external stent is placed over the wire (exchange of biliary drainage catheter, 47536). DOI: 10.15406/mojcr.2020.10.00346 Figure 1 Severe acute cholecystitis. Medical Coding. Eren Berber, Kristen L Engle, Andreas String, et.al. Acute cholecystitis tends to be one of the highest risks for conversion to open surgery-due to unclear anatomy, excessive bleeding or technical complications. A laparoscope is a long tube having a mounted camera for internal imaging that helps to place the . 0000010319 00000 n 0000004679 00000 n doi: 10.1016/j.suc.2008.07.005. Another example is when gastric contents have leaked and there is maceration, ulceration, or necrosis of the surrounding skin that requires debridement and management of a larger-than-normal gastrostomy tract for tube replacement. Prior to 2019, a single code, 43760, was used to report replacement of a G-tube without imaging or endoscopic guidance. 47540 describes the placement of a completely internal stent via a new access with separate placement of an external or internal/external biliary catheter. New Add-on Codes These abnormalities can occur anywhere in the collecting system, but most often are between the ampullary sphincter of the distal common bile duct and the bifurcation of the more proximal common bile duct. (not the gallbladder). Forty-four patients had the PCT removed and were managed non-operatively (30.1%) of which 5 developed recurrent . Unauthorized use of these marks is strictly prohibited. 0000266889 00000 n Indications for procedure: Patient is a 77 year old male who presented to the ED with abdominal pain. 0000278728 00000 n J Hepatobiliary Pancreat Surg 2007;14:551-6. In such situations, the tract may be difficult to access and require dilation and guidewires to place a new tube. Surgery was recommended. This month, well discuss the major changes in percutaneous biliary interventional coding. This may limit the number of cholangioplasties submitted in patients with sclerosing cholangitis. Ultrasound showed thickening of gallbladder with sludge, without evidence of stones. Patient underwent incision in the parotid gland to remove a calcified stone. 0000263069 00000 n 0000269288 00000 n In addition, CPT code 47562, which had previously been reviewed in 1995 and 2005, was used as a stable reference service when valuing CPT code 47563. It is performed under x-ray or ultrasound. Bickel A, Hoffman RS, Loberant N, Weiss M, Eitan A. Surg Endosc. Heres a rundown of how to apply the new codes. 0000264401 00000 n Kevin M. Bradley and Daniel T. Dempsey. However, for 2013, CMS did not agree with the RUC and instead further reduced the wRVU for 47562 to correct the rank order anomaly that CMS created when it reduced the wRVU for 47563. A gastrostomy tube, or G-tube, is a tube inserted through the abdomen to deliver nutrition directly into the stomach.Prior to 2019, a single code, 43760, was used to report replacement of a G-tube . He has been covering medical coding and billing, healthcare policy, and the business of medicine since 1999. Gallbladder wall was very thick-walled and there was generalized excessive bleeding from around the liver bed. 0000267732 00000 n The CPT code is 47564. 0000010472 00000 n . 42330. Figure 2 Laparoscopic cholecystostomy tube. Unable to load your collection due to an error, Unable to load your delegates due to an error. 0000207672 00000 n 0000304051 00000 n Do not report 47531, as its bundled with this conversion). 2006). Question: Our surgeon performed the following procedures on a patient (CPT codes): 66185 Tube revision; 67120 Removal of tube; 67255 Graft at removal site; 66180 Insertion of new tube in different area; As there are bundling edits, are we able to unbundle and submit each procedure? Check the "cholecystostomy tube exchange cpt code" Portal here to get the information that you are looking for and Just click on the result pages. 41010. Unauthorized use of these marks is strictly prohibited. 0000291427 00000 n 0000266041 00000 n Percutaneous placement of cholecystostomy drain has been used in . Cholecystostomy Tube Placement. Laparoscopic cholecystostomy as an alternative to open cholecystectomy and percutaneous cholecystostomy in a rural setting. Do not submit 47541 when a pre-existing catheter is accessed to perform the rendezvous procedure. 0000265781 00000 n Am J Surg. Twelve biliary CPT codes were deleted for 2016 (47500, 47505, 47510, 47511, 47525, 47530, 47630, 74305, 74320, 74327, 75980, and 75982), and five previously recommended endoscopic codes (47552, 47553, 47554, 47555, and 47556) should no longer be used for percutaneous procedures because new codes more accurately describe these procedures. This procedure may be reported with new codes for tube check (47531), tube change (47536), tube removal (47537), and stone extraction (47544). Affiliation 1 Department of Surgery, Section of . Do not use this code when a balloon catheter is used for stone extraction. . The balloon was inflated within the gallbladder to secure it in place. permits unrestricted use, distribution, and build upon your work non-commercially. Offer. <<6AE50061E6B09F4EB2BBF1F9DB67FCB9>]/Prev 500599/XRefStm 4256>> Gadacz TR, Crist DW. 0000266995 00000 n LC tube placement can also be used where interventional radiology (IR) services are not available. Diagnostic cholangiogram is performed (47531), demonstrating a distal common bile duct stenosis. LC tube placement remains an alternative to open surgery in cases where the gallbladder is too inflamed to allow for laparoscopic removal, and in cases where the patient is too sick to tolerate a more extensive procedure. A retrospective observational study of image-guided percutaneous cholecystostomy was performed from 2004 to 2016. Hence decided to perform LCtube placement. In these cases, replacement of the G-tube is straightforward and would be reported with code 43762, CPT Assistantcontinues, and provides the following example: A 76-year-old female suffering from significant malnutrition previously required placement of a percutaneous gastrostomy tube. A percutaneous cholecystostomy is a procedure to place a drainage catheter in the gallbladder through a tiny entry hole made in the stomach wall. It should reduce the number of patients who require open surgery for removal of the gallbladder. which Percutaneous cholecystostomy, which includes placement of a drainage catheter into the gallbladder (47490 Cholecystostomy, percutaneous, complete procedure, including imaging guidance, catheter placement, cholecystogram when performed, and radiological supervision and interpretation), remains unchanged in 2016. For 2016, the biggest CPT coding changes affecting interventional radiology occur within the subspecialties of urinary, biliary, and neurologic intervention. Question? Additionally, CPT code 47563 was reviewed in October 2010. National Library of Medicine 0000262962 00000 n Keywords: laparoscopic cholecystostomy tube, acute cholecystitis, Laparoscopic cholecystectomy is one of the most common procedures performed in the world today. Best answers. Masaya Yamoto, Naoto Urushihara, Koji Fukumoto, et al. 0000267575 00000 n J Laparoendosc Adv Surg Tech A. If I am stuck with an unlisted code, would it be best to simply code for the diagnostic laparoscopy and call the drain placement inclusive? Please help me with the coding of this procedure. Ct-guided cholecystotomy tube placement. Surg Endosc. 0000264507 00000 n 527 155 0000007054 00000 n Right hip pain ICD 10 coding is made easier with our billing guidelines. 0000268664 00000 n The preferred treatment for acute cholecystitis is laparoscopic cholecystectomy. As a contributor you will produce quality content for the business of healthcare, taking the Knowledge Center forward with your knowhow and expertise. Best viewed in Mozilla Firefox | Google Chrome | Above IE 7.0 version | Opera | Terms and Conditions | Privacy Policy, Laparoscopic cholecystostomy tube placement. endstream endobj 528 0 obj <>/Metadata 119 0 R/Names 529 0 R/Outlines 81 0 R/PageLabels 116 0 R/Pages 118 0 R/StructTreeRoot 121 0 R/Type/Catalog/ViewerPreferences<>>> endobj 529 0 obj <> endobj 530 0 obj <>/ExtGState<>/Font<>/ProcSet[/PDF/Text/ImageC/ImageI]/Shading<>/XObject<>>>/Rotate 0/StructParents 8/TrimBox[0.0 0.0 595.276 841.89]/Type/Page>> endobj 531 0 obj [532 0 R 533 0 R] endobj 532 0 obj <>/Border[0 0 0]/H/N/Rect[435.42 52.6564 534.666 45.5704]/StructParent 29/Subtype/Link/Type/Annot>> endobj 533 0 obj <>/Border[0 0 0]/H/N/Rect[490.0 775.236 560.91 751.97]/StructParent 9/Subtype/Link/Type/Annot>> endobj 534 0 obj <> endobj 535 0 obj <> endobj 536 0 obj <>stream 0000280217 00000 n and transmitted securely. . 0000025038 00000 n All trials were at high risk of bias. The CPT code for removal of a gastrostomy tube is 43999. 2020 cheeyandira. Unable to load your collection due to an error, Unable to load your delegates due to an error. Before 530.4 Perforation of Esophagus (ICD 9) ICD-10 Code K22.4 Dyskinesia of Esophagus. The stent codes may be used more than two times in individuals requiring multiple stents to treat multiple stenoses in different ducts. Use this code only once per session. 0000278194 00000 n We are looking for thought leaders to contribute content to AAPCs Knowledge Center. In this arm, investigators perform only laparoscopic cholecystectomy, and not insert a drain. Interventional Radiology . )GxGxGxGxGxGCa Do not submit 47533 or 47534 with this procedure. Laparoscopic cholecystostomy with delayed cholecystectomy as an alternative to conversion to open procedure. Laparoscopic cholecystectomy can be quite challenging in especially in certain situations. Clinical Documentation and Prior Authorization Required Tufts healh plan required authorization for below services. Ultrasound scan of the liver showed thickening of the gallbladder with gallbladder stones. What are the contraindications for laparoscopic cholecystectomy? 47537 describes the removal of an existing external or internal/external biliary drainage catheter, and includes diagnostic imaging. Phone: +36 180 38 002, Email: support@medcrave.com More Locations 0000295215 00000 n 0000010370 00000 n Epub 2021 Sep 7. Earn CEUs and the respect of your peers. Cholangioplasty is bundled when performed at the same site as a biliary stent deployment. Inpatient procedure costs include the hospital payment for the entire stay associated with the surgery. 0000207938 00000 n 0000262431 00000 n This resulted in a rank order anomaly for 2012(47562 wRVU = 11.87; 47563 wRVU = 11.47). 0000265145 00000 n Copyright 2023, AAPC Here we present 2 cases with severe acute cholecystitis that required placement of laparoscopic cholecystostomy (LC) tube. As a contributor you will produce quality content for the business of healthcare, taking the Knowledge Center forward with your knowhow and expertise. Gurusamy KS, Koti R, Davidson BR. Three add-on procedures: The three patients underwent successful interval laparoscopic cholecystectomy. Privacy Policy | Terms & Conditions | Contact Us. You are using an out of date browser. Patient had CT scan on 10/21/2009 demonstrating a persistent . Median tube placement duration was 25 days (range 1-211). The patients received 48 h of antibiotics in the hospital and then underwent tube drainage for 4-6 weeks as outpatients. Cholangioplasty at the site of a stent placement during the same session is bundled and not separately coded. Procedure: Diagnostic laparoscopy, cholecystostomy tube placement (14Fr mic feeding tube) Anesthesia: General Surgery. Physicians are advised to use the CPT code that accurately describes the basic surgical procedure. Submit 47537 once for each catheter removed at the same session. The drainage tube will be connected to a collection bag which can be periodically emptied. 0 0000101850 00000 n The CPT code is 56304. Citation: cheeyandira A. Laparoscopic cholecystostomy tube placement. CCY cholecystectomy, CCYT-tube cholecystostomy-tube from publication: Percutaneous cholecystostomy-tube for high-risk patients with acute cholecystitis: current practice and implications for . The authors have no conflicts of interest to declare. October 2015. Same Old Code May Be Used with New Codes Laparoscopic tube cholecystostomy remains an alternative to open surgery in cases where the gallbladder is judged too inflamed to allow for laparoscopic removal and in cases where the patient is too sick to tolerate a more extensive procedure. Cholangioplasty is performed (+47542). You must log in or register to reply here. He is an alumnus of York College of Pennsylvania and Clemson University. Acute cholecystitis and recurrent biliary colic are the most common indications for performing laparoscopic cholecystectomy. 0000005679 00000 n %%EOF At that time the RUC recommended a wRVU of 12.11 for CPT code 47563, however, CMS reduced the value to 11.47. Percutaneous cholecystostomy is the image-guided placement of a drainage catheter into the gallbladder lumen. Accessibility Patients undergoing uncomplicated laparoscopic cholecystectomy for symptomatic cholelithiasis may be discharged home on the day of surgery (Tenconi, et al. The gallbladder itself appeared thickened, contracted and was very friable (Figure 1). This is a minimally invasive procedure. 0000012348 00000 n Type II Add-on codes do not have a defined set of primary procedure codes identified by AMA CPT. 2016 Mar;30(3):1028-33. doi: 10.1007/s00464-015-4290-y. In March, we covered urinary intervention. Early surgery is associated with better results in comparison to delayed surgery.1, Acute cholecystitis tends to be one of the highest risks for conversion to open surgery-due to unclear anatomy, excessive bleeding or technical complications.2,3, LC tube placement remains an alternative to open surgery in cases where the gallbladder is too inflamed to allow for laparoscopic removal, and in cases where the patient is too sick to tolerate a more extensive procedure. If more than two separate sites are treated with balloon dilation, no additional codes are submitted for the additional cholangioplasties. MOJ Clin Med Case Rep . John Verhovshek, MA, CPC, is a contributing editor at AAPC. If the radiologist leaves in a drainage catheter, 47533 or 47534 should be submitted instead of 47541. This technique is also favorable from a cosmetic viewpoint because the resultant wound can be reused as the trocar insertion site at the time of laparoscopic cyst excision.8. For the Cy2013 PFS, these codes are correctly ranked. %PDF-1.4 % 0000210646 00000 n Access placement to assist with endoscopic biliary procedure The percutaneous cholecystostomy course may be transhepatic, where the catheter tra-verses the liver before entering the gallblad-der, or gallbladder access may be directly Image-Guided Cholecystostomy Tube Placement: Short- and Long-Term Outcomes of Transhepatic Versus Transperitoneal Placement Michael D. Beland1 Lakir Patel2 Sun H. Ahn1 The role of a colon resection in combination with a Malone appendicostomy as part of a bowel management program for the treatment of fecal incontinence. C. As CPT Assistantnotes, however, that for some patients: replacing a G-tube is more complicated, such as when a gastrostomy tract has not matured or when the G-tube has been out for many hours or in cases where cooperation of the patient is difficult, as in some children or confused patients. In a study by Joseph et al., 32% of critically ill patients who had a cholecystostomy tube placed did not improve or declined clinically after cholecystostomy tube placement. 0000262534 00000 n Is it because the word external in 47533? 0000305890 00000 n October 2015 . ;Gm 47531 Injection procedure for cholangiography, percutaneous, complete diagnostic procedure including imaging guidance (eg, ultrasound and/or fluoroscopy) and all associated radiological supervision and interpretation; existing access DOI: 10.15406/mojcr.2020.10.00346. would be reported with code 43763. Date: Dec 14, 2018. The patient has a known filling defect in the region of the distal common bile duct, and is here for biopsy. 0000266782 00000 n Open Access by MedCrave Group is licensed under a Creative Commons Attribution 4.0 International License. 0000311637 00000 n What is a cholecystostomy tube? Use of modifier 22 is not appropriate if the sole use of the modifier . Excluding the 2 patients who died, the average hospital stay for the cholecystostomy procedure was 9.8 days (range, 1-21 days). This article includes all medical codes you will need to report right hip pain and related specific ICD 10 & 11 codes. 0000204916 00000 n Tech & Innovation in Healthcare eNewsletter, Excision of Benign or Malignant Skin Lesion, Surgical Complication Diagnostic Coding: Quick Tip. 2006 Apr;20(4):624-7. doi: 10.1007/s00464-005-0343-y. oFT52HJm9` @C{7k^$3d4o^7|q'pKxHZ:a[0z-c(]Z%%3FchJta 0000081587 00000 n 0000263498 00000 n If multiple overlapping stents are placed via a single access, only one stent procedure code is submitted. Trocar Cholecystostomy. T-tube drainage versus primary closure after laparoscopic common bile duct exploration. As explained in the February 2019 CPT Assistant: Gastrostomy tubes (G-tubes) may be inadvertently removed if traction is placed on the tube. The opportunity for coding specificity has never been better. Wu X, Yang Y, Dong P, et al. Laparoscopic cholecystostomy for acute acalculous cholecystitis. Surgeons should be aware that an unlisted procedure requires documentation that provides relevant information, including a proper definition . As well, all of the new codes bundle the use of imaging guidance, including fluoroscopy, ultrasound, computed tomography (CT), and magnetic resonance imaging (MRI). 0000292586 00000 n +47544 describes percutaneous biliary stone extraction by any method, and includes removal of stone(s) with a basket and/or pushed through the ampulla with a balloon. Laparoscopic tube cholecystostomy: still useful in the management of complicated acute cholecystitis. The first endoscopic cholecystostomy was . 527 0 obj <> endobj 0000012605 00000 n Best answers. Medical Billing and Coding Books and Software | OptumCoding Benefit coverage for health services is determined by the member specific benefit plan document and applicable laws that may require coverage for a specific service. Post-procedure, 16 patients (43.24%) went on to have LC, of which 50% (eight patients) required conversion to open surgery and 25% (four . 0000102401 00000 n In the drain insertion group, investigators use the closed suction drain through a lateral 5-mm trocar and placed it in right subhepatic space. 0000205882 00000 n Operation: Exploratory laparoscopy with extensive lysis of adhesions totaling 1 hour and insertion of cholecystostomy tube under laparoscopic guidance A 5 mm trocar was attempted to be placed in the upper midline which was ultimately unsuccessful due to intra-abdominal adhesions despite being above the level of the incision. All three codes include an initial cholangiogram (47532, 47531) and all imaging guidance (e.g., fluoroscopy, ultrasound, CT, MRI). . Regret for the inconvenience: we are taking measures to prevent fraudulent form submissions by extractors and page crawlers. 0000212119 00000 n 0000010623 00000 n I think the new incision does count, and the code includes the imaging but I don't think the imaging needs to happen per se. At this point it was decided to perform LC tube placement in order to avoid injury to the vital structures. 0000265938 00000 n Historically, surgical options have included the Malone antegrade continence enema, using an appendicostomy for antegrade colonic enemas. 0000262177 00000 n government site. CPT 2016:Percutaneous Biliary Interventional Coding, Tech & Innovation in Healthcare eNewsletter, Capture the Complete Clinical Picture With Precision, Applying RVUs to Pharmacists Patient Care Services, Three Tidbits Help You Code Lesion Biopsy and Removal, Consider All Factors when Coding Colonoscopies, Mohs Micrographic Surgery for Clear Coding, Members Tip: Pain-free Coding of Mortons Neuroma. Contrast is injected and imaging is performed and interpreted. There is no imaging guidance, it technically is not done "percutaneously" although a "new incision" was created but I don't think that counts. An imaging code (47531 or 47532) can be submitted instead if the above catheter codes are not performed. An imaging code (47531 or 47532) can be submitted instead if the above catheter codes are not performed. Because imaging guidance is performed, be sure the ultrasound, CT, or MRI tech does not charge a guidance code when the access uses one of these imaging guidance modalities. Biliary endoscopy, percutaneous via T-tube or other tract; with dilation of biliary duct stricture(s) with stent +CPT Code 47550 is an Add-On code and must be reported with a primary procedure. Nov 5, 2009. The procedure of gall bladder removal and Cholecystostomy removal can be performed side by side with the help of laparoscope computer imaging. The cholangiogram may be performed via a new access (placing a needle or catheter through the right side or anterior abdominal wall into the right or left bile ducts respectively) or via a pre-existing catheter, usually an existing biliary catheter. Disclaimer. 0000101920 00000 n 0000006018 00000 n official website and that any information you provide is encrypted CPT code 47560 describes a diagnostic laparoscopy plus laparoscopic-guidance for percutaneous insertion of a needle or catheter into the liver parenchyma to access the biliary tree for injection of contrast and performance of trans-hepatic cholangiography. In 1999, Lillemoe, et al. You can easily access coupons about "Cpt Code Cholecystostomy Tube Placement" by clicking on the most relevant deal below. Code Description0FJB4ZZ Inspection of Hepatobiliary Duct, Percutaneous Endoscopic Approach0FT44ZZ Resection of Gallbladder, Percutaneous Endoscopic ApproachBF10YZZ Fluoroscopy of Bile Ducts using Other ContrastBF50200 Other Imaging of Bile Ducts using Fluorescing Agent, Indocyanine Green Dye, IntraoperativeBF502Z0 Other Imaging of Bile Ducts using Fluorescing Agent, IntraoperativeBF52200 Other Imaging of Gallbladder using Fluorescing Agent, Indocyanine Green Dye, IntraoperativeBF522Z0 Other Imaging of Gallbladder using Fluorescing Agent, IntraoperativeBF53200 Other Imaging of Gallbladder and Bile Ducts using Fluorescing Agent, Indocyanine Green Dye, IntraoperativeBF532Z0 Other Imaging of Gallbladder and Bile Ducts using Fluorescing Agent, Intraoperativ, Your email address will not be published. Laparoscopic cholecystostomy tube placement can be a useful adjunct in situations where there is severe acute inflammation of the gallbladder and can avoid conversion to open procedure. HHS Vulnerability Disclosure, Help A 2018 study demonstrated no difference in mortality between percutaneous . These procedures are more complicated and . 0000264294 00000 n Since the development of this procedure, multiple alternatives have been developed, including the Chait cecostomy tube. No Intervention: no drain insertion. This allows for performing interval laparoscopic cholecystectomy in a safe manner. The https:// ensures that you are connecting to the 1991 Mar;161(3):339-44 2008). Anatomically Speaking 0000267926 00000 n At the time of surgery, three of the 100 patients had gallbladders judged too severely inflamed for laparoscopic cholecystectomy. Procedure: Laparoscopic cholecystectomy with drain insertion. Laparoscopic cholecystectomy is a covered surgical procedure in which a diseased gall bladder is removed through the use of instruments introduced via cannulae, with vision of the operative field maintained by use of a high-resolution television camera-monitor system (video laparoscope). The biliary system is divided into right- and left-sided bile ducts; however, these ducts divide further into multiple smaller branches that may be individually accessed and drained, depending on the pathology treated (e.g., Klatskin tumor is a cholangiocarcinoma that has involved and caused bifurcation occlusions of the common bile duct. For 2019, the CPT codebook made changes that affect proper coding for replacement or change of a gastrostomy tube. 0000263284 00000 n These codes include both the surgical and supervision and interpretation (S&I) components of the procedure. He developed bilateral pleural effusions and had a right-sided thoracocentesis performed. . Do not submit 47536 or 47537 with this procedure. With the new codes added in 2016, a comprehensive set of biliary codes is now available to describe almost every procedure performed in the biliary system. Curr Urol Rep. 2019 Jun 10;20(8):41. doi: 10.1007/s11934-019-0909-1. LC tube placement can be used as an alternative to open cholecystectomy in technically difficult cases and alternative to IR percutaneous cholecystostomy in rural hospitals without interventional radiology services.5 There are other indications for LC tube placement -such as in children with complicated choledochal cyst- where LC tube placement followed by laparoscopic cyst excision is a useful and safe procedure for the treatment of complicated choledochal cyst. 47539 describes the placement of a completely internal stent via a new access without leaving a biliary catheter at the end of the procedure. 6 weeks from the time of the original surgery, the patient underwent elective outpatient procedure - laparoscopic cholecystectomy was performed and removal of cholecystostomy tube.
