Advanced gallbladder inflammation is a risk factor for gallbladder perforation in patients with acute cholecystitis

ABSTRACT Background: Laparoscopic cholecystectomy is the preferable treatment for chronic or acute cholecystitis. Some factors may increase the rate of laparoscopic conversion to open cholecystectomy and perioperative complications. The role of gender as a risk factor for laparoscopic cholecystectomy is controversial. Aim: To evaluate the role of the gender on the operative findings and outcome of laparoscopic cholecystectomy. Method: All patients who underwent laparoscopic cholecystectomy for chronic or acute cholecystitis were included. Demographic, clinical, laboratory, imaging exams, intraoperative and postoperative data were obtained and analyzed. The data was obtained retrospectively from electronic medical records and study protocols. Results: Of a total 1,645 patients who were subjected to laparoscopic cholecystectomy, 540 (32.8%) were men and 1,105 (67.2%) were women. Mean age was similar in both genders (p=0.817). Operative time has longer in the male (72.48±28.50) than in the female group (65.46±24.83, p<0.001). The rate of acute cholecystitis was higher in the male (14.3%) than in the female group (5.1%, p<0.001). There was no difference between the genders in regard to the rate of conversion (p=1.0), intraoperative complication (p=1.0), postoperative complication (p=0.571), and operative mortality (p=1.0). Conclusion: Male gender is not an independent risk factor for laparoscopic conversion and perioperative complications.

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Critically ill patients with acute cholecystitis are at increased risk for extensive gallbladder inflammation

World Journal of Emergency Surgery ◽

10.1186/s13017-015-0054-1 ◽

2015 ◽

Vol 10 (1) ◽

Cited By ~ 13

Author(s):

Marios Papadakis ◽

Peter C. Ambe ◽

Hubert Zirngibl

Keyword(s):

Acute Cholecystitis ◽

Critically Ill ◽

Critically Ill Patients ◽

Increased Risk ◽

Gallbladder Inflammation

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Ultrasonography in Acute Gallbladder Perforation

Acta Radiologica ◽

10.1177/028418518802900108 ◽

1988 ◽

Vol 29 (1) ◽

pp. 41-44 ◽

Cited By ~ 7

Author(s):

M. Soiva ◽

M. Pamilo ◽

M. Päivänsalo ◽

M. Taavitsainen ◽

I. Suramo

Keyword(s):

Acute Cholecystitis ◽

Peritoneal Fluid ◽

Gallbladder Wall ◽

Control Group ◽

Gallbladder Perforation ◽

University Hospitals ◽

Fluid Collections ◽

Free Peritoneal Fluid

The files of patients with acute cholecystitis from two large university hospitals from the years 1978–1985 were employed to find the cases with acute gallbladder perforation for this study. Only those patients (n=9) were selected for the analysis of sonographic signs of acute gallbladder perforation who had less than 48 hours of symptoms before sonography, and were operated upon within 24 hours of the sonography. Patients (n=10) with non-complicated acute cholecystitis and identical in regard to the duration of the symptoms and the timing of the sonography and the operation formed a control group. The sonographic findings in patients with gallbladder perforation were pericholecystic fluid collections, free peritoneal fluid, disappearance of the gallbladder wall echoes, focal highly echogenic areas with acoustic shadows in the gallbladder, and an inhomogeneous, generally echo-poor gallbladder wall.

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Effect of Indomethacin on Gallbladder Inflammation and Contractility during Acute Cholecystitis

Journal of Surgical Research ◽

10.1006/jsre.2001.6082 ◽

2001 ◽

Vol 96 (1) ◽

pp. 135-142 ◽

Cited By ~ 15

Author(s):

Henry P. Parkman ◽

Arlene N. James ◽

Rebecca M. Thomas ◽

Lori L. Bartula ◽

James P. Ryan ◽

...

Keyword(s):

Acute Cholecystitis ◽

Gallbladder Inflammation

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Laparoscopic cholecystectomy for acute cholecystitis and the consequences of gallbladder perforation, bile spillage, and “loss” of stones

The European Journal of Surgery ◽

10.1080/110241598750004238 ◽

2003 ◽

Vol 164 (6) ◽

pp. 425-431 ◽

Cited By ~ 22

Author(s):

Yaron Assaff ◽

Ibrahim Matter ◽

Edmond Sabo ◽

Jorge G. Mogilner ◽

Ernest Nash ◽

...

Keyword(s):

Laparoscopic Cholecystectomy ◽

Acute Cholecystitis ◽

Gallbladder Perforation ◽

Bile Spillage

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A rare complication of cholecystolithiasis: perforation of the gallbladder

Journal of Ultrasonography ◽

10.15557/jou.2021.0009 ◽

2021 ◽

Vol 21 (84) ◽

pp. e63-e66

Author(s):

Bartosz Migda ◽

◽

Marlena Alicja Gabryelczak ◽

Anna Migda ◽

Katarzyna Prostacka ◽

...

Keyword(s):

Acute Pancreatitis ◽

Rare Complication ◽

Gallstone Ileus ◽

Mirizzi Syndrome ◽

The Other ◽

Gallbladder Perforation ◽

Appropriate Care ◽

History Of ◽

Complications Of Cholelithiasis ◽

Gallbladder Inflammation

Common complications of cholelithiasis include gallbladder inflammation, cholangitis, and acute pancreatitis. On the other hand, rare complications include gallbladder carcinoma, gallstone ileus, Mirizzi syndrome and gallbladder perforation. Some patients with cholecystitis do not require hospitalization. It is of key importance for proper further diagnosis and treatment to remember about the possible complications of cholecystitis, especially in oligosymptomatic patients. Therefore, ultrasound examinations in patients with a history of gallbladder stones should be performed with appropriate care. Ultrasound should be performed carefully in patients with a history of cholecystolithiasis, especially those oligosymptomatic, bearing in mind that there are some rare complications of this highly common clinical entity.

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Gallbladder perforation: management in a tertiary care centre

International Surgery Journal ◽

10.18203/2349-2902.isj20184086 ◽

2018 ◽

Vol 5 (10) ◽

pp. 3346

Author(s):

Prashant Tubachi ◽

K. Sphurti Kamath ◽

Mallikarjun Desai ◽

Harsha Kodliwadmath

Keyword(s):

Surgical Treatment ◽

Acute Cholecystitis ◽

Computerized Tomography ◽

Open Cholecystectomy ◽

Tertiary Care ◽

Diagnostic Procedures ◽

Gallbladder Perforation ◽

Type I ◽

Tertiary Care Centre ◽

Intravenous Antibiotics

Background: Retrospective study in the management of perforated gallbladder and clinical outcome in a tertiary care centre.Methods: Total of 583 patients underwent laparoscopic or open cholecystectomy between 2015 to 2017. Out of these eleven patients had perforated gallbladder (1.9%). Niemeier’ classification used for gallbladder perforation. Both Ultrasonography and Abdominal computerized tomography was used in this study. The parameters like age, gender, method of management, diagnostic procedures, time between date of admission to time of surgery, surgical treatment, duration of hospital stay and post-operative morbidity were evaluated.Results: Out of the eleven cases, eight patients were male and three were female. Nine patients were above the age of fifty years. According to Niemer classification, seven patients had type I perforation, three patients had type II perforation and one had type one perforation. Out of the eleven cases, eight were clinically diagnosed to be acute cholecystitis and three were clinically diagnosed to have peritonitis. The cases diagnosed to have peritonitis- underwent immediate intervention. The remaining eight cases were initially managed conservatively with intravenous antibiotics, imaging and workup was done, following which intervention was done.Conclusions: Early diagnosis and emergency surgical treatment of gallbladder perforation with peritonitis is of crucial importance. If the patient is stable then intervention after optimising has better outcome. Abdominal computerized tomography for acute cholecystitis patients may contribute to the preoperative diagnosis of gallbladder perforation.

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