Laparoscopic Management Of Assessory Gall Bladder & Tips For Surgeons

Postcholecystectomy Mirizzi syndrome (PCMS) is an uncommon entity that can occur due to cystic duct stump calculus, gall bladder remnant calculus or migrated surgical clip. It can be classified into early PCMS or late PCMS. It is often misdiagnosed and the management depends on the site of impaction of stone or clip. Endoscopy can be performed for cystic duct stump calculus. However, surgery is the treatment for remnant gall bladder calculus. Role of laparoscopic management is controversial. We present here a case of a 48-year-old woman with late PCMS due to an impacted calculus in a sessile gall bladder remnant following a subtotal cholecystectomy, managed with laparoscopic completion cholecystectomy, review the literature, provide tips for safe laparoscopy for PCMS and summarise our algorithmic approach to the management of the postcholecystectomy syndrome.

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Laparoscopic management of gall bladder perforation secondary to typhoid-induced acalculous cholecystitis: A rare entity

Journal of Minimal Access Surgery ◽

10.4103/jmas.jmas_30_19 ◽

2020 ◽

Vol 16 (3) ◽

pp. 276

Author(s):

Vivek Bindal ◽

Anupam Goel ◽

Sudhir Kalhan ◽

Parveen Bhatia ◽

Mukund Khetan ◽

...

Keyword(s):

Gall Bladder ◽

Acalculous Cholecystitis ◽

Bladder Perforation ◽

Rare Entity ◽

Laparoscopic Management

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Gallbladder perforation in acute acalculous cholecystitis: an atypical manifestation of dengue fever

International Surgery Journal ◽

10.18203/2349-2902.isj20181614 ◽

2018 ◽

Vol 5 (5) ◽

pp. 1943 ◽

Cited By ~ 1

Author(s):

Nikhil Deshmukh ◽

Alok Rath ◽

Sridhar Reddy M. ◽

Naresh M.

Keyword(s):

Gall Bladder ◽

Dengue Fever ◽

Acalculous Cholecystitis ◽

Bladder Perforation ◽

Wound Complications ◽

Gallbladder Perforation ◽

Acute Acalculous Cholecystitis ◽

Small Subset ◽

Early Recovery ◽

Laparoscopic Management

Among the atypical manifestations of dengue fever, comprising 15.8% of all cases, acalculous cholecystitis forms a small subset. Acalculous cholecystitis is managed conservatively in majority of cases and a chance of gall bladder perforation is low (2-18%). Management of gall bladder perforation in the scenario of Dengue is sometimes complicated by presence of thrombocytopenia and its complications thereof. Mortality associated with gall bladder perforation is relatively high. Gallbladder usually perforates at the fundus and is to be dealt with surgically if it doesn’t localize. Laparoscopic management of gall bladder perforation is feasible as calot’s is relatively virgin (as there is no calculous disease). Thorough peritoneal toileting is possible and a chance of intra-abdominal abscess in post-operative period is a mere speculation. Laparoscopic management results in early recovery and fewer wound complications and lesser hospital stay.

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