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Gallbladder perforation: a single center experience of 32 cases.

Gunasekaran G, Naik D, Gupta A, Bhandari V, Kuppusamy M, Kumar G, Chishi NS - Korean J Hepatobiliary Pancreat Surg (2015)

Bottom Line: The mean age of patients was 55.9 years.The histopathologic analysis in 28 patients who were operated on showed acute cholecystitis in 19 cases, acute-on-chronic cholecystitis in 4 cases, chronic cholecystitis in 4 cases, and mucinous adenocarcinoma of the gallbladder in a single case.Appropriate classification and management are essential.

View Article: PubMed Central - PubMed

Affiliation: Department of Surgery, Vardhman Mahavir Medical College and Safdarjung Hospital, New Delhi, India.

ABSTRACT

Backgrounds/aims: Gallbladder perforation is a rare but potentially fatal disease. We herein present our clinical experience in diagnosis and management of 32 cases of gallbladder perforation.

Methods: This retrospective study was conducted with inclusion of all cases of gallbladder perforation that presented to our hospital from January 2012 to November 2014. Cases of traumatic gallbladder perforation and patients younger than 12 years of age were excluded from this study.

Results: This study included 32 patients (13 males and 19 females). The mean age of patients was 55.9 years. Gallbladder perforation was most common in the 5th and 6th decade of life. The mean age of patients with type I, II, and III gallbladder perforation was 57.0 years, 57.6 years, and 49.8 years, respectively. The most common site of perforation was the fundus, followed by the body and Hartmann's pouch (24 : 5 : 2). Most of the type I gallbladder perforations were diagnosed intraoperatively, type II gallbladder perforations were diagnosed by enhanced abdominal computed tomography, and type III gallbladder perforations were diagnosed during laparoscopic cholecystectomy converted to open cholecystectomy for cholelithiasis. Mortality was highest in patients with type I gallbladder perforation. The mean hospital stay was 10.1 days, 6.4 days, and 9.2 days in patients with type I, II, and III gallbladder perforation, respectively. The histopathologic analysis in 28 patients who were operated on showed acute cholecystitis in 19 cases, acute-on-chronic cholecystitis in 4 cases, chronic cholecystitis in 4 cases, and mucinous adenocarcinoma of the gallbladder in a single case.

Conclusions: Gallbladder perforation represents a special diagnostic and surgical challenge. Appropriate classification and management are essential.

No MeSH data available.


Related in: MedlinePlus

Cholecystectomy specimen showing perforation in the body of the gallbladder.
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Figure 4: Cholecystectomy specimen showing perforation in the body of the gallbladder.

Mentions: Most of the spontaneous gallbladder perforations were diagnosed intraoperatively (9 gallbladder perforations were diagnosed during exploratory laparotomy for perforation peritonitis and 7 gallbladder perforations were diagnosed while the patients were undergoing laparoscopic cholecystectomy for cholelithiasis). Most of the type I gallbladder perforations were diagnosed intraoperatively (Figs. 3, 4), type II gallbladder perforations were diagnosed by enhanced abdominal computed tomography (CT), and type III gallbladder perforations were diagnosed during laparoscopic cholecystectomy converted to open cholecystectomy for cholelithiasis. Abdominal ultrasonography was useful in diagnosing 5 cases of gallbladder perforation and magnetic resonance cholangiopancreatography (MRCP) was useful in diagnosing 2 cases of gallbladder perforation (Fig. 5).


Gallbladder perforation: a single center experience of 32 cases.

Gunasekaran G, Naik D, Gupta A, Bhandari V, Kuppusamy M, Kumar G, Chishi NS - Korean J Hepatobiliary Pancreat Surg (2015)

Cholecystectomy specimen showing perforation in the body of the gallbladder.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4494096&req=5

Figure 4: Cholecystectomy specimen showing perforation in the body of the gallbladder.
Mentions: Most of the spontaneous gallbladder perforations were diagnosed intraoperatively (9 gallbladder perforations were diagnosed during exploratory laparotomy for perforation peritonitis and 7 gallbladder perforations were diagnosed while the patients were undergoing laparoscopic cholecystectomy for cholelithiasis). Most of the type I gallbladder perforations were diagnosed intraoperatively (Figs. 3, 4), type II gallbladder perforations were diagnosed by enhanced abdominal computed tomography (CT), and type III gallbladder perforations were diagnosed during laparoscopic cholecystectomy converted to open cholecystectomy for cholelithiasis. Abdominal ultrasonography was useful in diagnosing 5 cases of gallbladder perforation and magnetic resonance cholangiopancreatography (MRCP) was useful in diagnosing 2 cases of gallbladder perforation (Fig. 5).

Bottom Line: The mean age of patients was 55.9 years.The histopathologic analysis in 28 patients who were operated on showed acute cholecystitis in 19 cases, acute-on-chronic cholecystitis in 4 cases, chronic cholecystitis in 4 cases, and mucinous adenocarcinoma of the gallbladder in a single case.Appropriate classification and management are essential.

View Article: PubMed Central - PubMed

Affiliation: Department of Surgery, Vardhman Mahavir Medical College and Safdarjung Hospital, New Delhi, India.

ABSTRACT

Backgrounds/aims: Gallbladder perforation is a rare but potentially fatal disease. We herein present our clinical experience in diagnosis and management of 32 cases of gallbladder perforation.

Methods: This retrospective study was conducted with inclusion of all cases of gallbladder perforation that presented to our hospital from January 2012 to November 2014. Cases of traumatic gallbladder perforation and patients younger than 12 years of age were excluded from this study.

Results: This study included 32 patients (13 males and 19 females). The mean age of patients was 55.9 years. Gallbladder perforation was most common in the 5th and 6th decade of life. The mean age of patients with type I, II, and III gallbladder perforation was 57.0 years, 57.6 years, and 49.8 years, respectively. The most common site of perforation was the fundus, followed by the body and Hartmann's pouch (24 : 5 : 2). Most of the type I gallbladder perforations were diagnosed intraoperatively, type II gallbladder perforations were diagnosed by enhanced abdominal computed tomography, and type III gallbladder perforations were diagnosed during laparoscopic cholecystectomy converted to open cholecystectomy for cholelithiasis. Mortality was highest in patients with type I gallbladder perforation. The mean hospital stay was 10.1 days, 6.4 days, and 9.2 days in patients with type I, II, and III gallbladder perforation, respectively. The histopathologic analysis in 28 patients who were operated on showed acute cholecystitis in 19 cases, acute-on-chronic cholecystitis in 4 cases, chronic cholecystitis in 4 cases, and mucinous adenocarcinoma of the gallbladder in a single case.

Conclusions: Gallbladder perforation represents a special diagnostic and surgical challenge. Appropriate classification and management are essential.

No MeSH data available.


Related in: MedlinePlus