Radiology, Vol 198, 85-88, Copyright © 1996 by Radiological Society of North America

ARTICLES

Outpatient percutaneous nephrostomy

RR Gray, CB So, RF McLoughlin, RA Pugash, JC Saliken and NI Macklin
Department of Diagnostic Imaging, Foothills Hospital, Calgary, Alberta, Canada.

PURPOSE: To assess the feasibility of performing percutaneous nephrostomy (PCN) on an outpatient basis in a select group of patients. MATERIALS AND METHODS: In 6 years, 60 PCN procedures were performed in a subgroup of 48 patients (22 men, 26 women) carefully selected from a larger group of 881 nephrostomy procedures in 589 patients. Exclusion criteria included hypertension; untreated urinary tract infection, coagulopathy, and staghorn calculi. Indications were calculus (n = 17), benign stricture (n = 10), and malignant ureteric obstruction (n = 21). RESULTS: There was 100% technical success. Six of 48 patients (12%) were admitted within a week of PCN; there were no cost savings in these patients. Three of these patients (6%) were admitted as a direct consequence of PCN; one had sepsis, one had bleeding, and one was unable to manage the PCN tube. Outpatient treatment saved the cost of hospitalization in 42 patients (88%). CONCLUSION: Outpatient PCN is feasible and safe in carefully selected patients and yields major cost savings because it precludes hospital admission.

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