Endoscopic transcystic stent placement for an intrahepatic abscess due to gallbladder perforation

Endoscopic cystic duct stent as primary treatment for intrahepatic gallbladder perforation with abscess formation

“…We are not aware of any other reported cases of transcystic stent placement as primary therapy in the literature. 5 The case we report followed a similar course, with a reduction in the size of the abscess following drain placement and resolution of septic symptoms. Similarly, the patient had no immediate complications from the procedure and, at six months follow-up, he remained symptom free with no late complications of the procedure.…”

“…3,4 In the case of malignant disease, ERCP has been used for drainage of abscesses related to both the left and right hepatic ducts and higher parts of the intrahepatic biliary tree. 5 In another case, transcystic stenting has been used as a 'salvage' procedure after a percutaneous drain became dislodged. Serial CT showed reduction in abscess size and resolution of septic symptoms following endoscopic transcystic drain placement.…”

Synchronous pyogenic liver abscess and acute cholecystitis: how to recognize it and what to do (emergency cholecystostomy followed by delayed laparoscopic cholecystectomy)

“…The length of hospital stay was 21.5 ± 3.5 days (range [18][19][20][21][22][23][24], and an elective LC was performed 12 ± 4 weeks (range 6-18) after ablation of the drain. Intraoperative cholangiogram was normal in all cases.…”

“…In series that have reported on patients affected by AC, a not inconsiderable 4.8-15% of patients were found to have a synchronous PLA [31,32], but the specific management of these patients were not described. Since only a few case reports describe this association [6][7][8][9][10][11][12][13][14][15][16][17][18][19][20][21] and regular articles ignore this potentially challenging situation, we here propose a simple protocol for a prompt diagnosis and an effective, miniinvasive treatment of PLA(s) associated with AC by emergency CS followed by elective LC. Since hyperpyrexia, upper-right-quadrant abdominal pain, hyperleukocytosis, and an increase in liver enzymes constitute typical features of both AC and PLA, a diagnosis of PLA in patients with AC may be difficult to achieve [10].…”

Liver abscess secondary to intrahepatic gallbladder perforation

“…Early laparoscopic cholecystectomy during acute cholecystitis appears to be safe and shortens the total hospital stay [27] provided that it is performed by a laparoscopy-oriented surgeon [28]. Recent literature has also published a case of an intrahepatic abscess due to gallbladder perforation, successfully treated by endoscopic stent placement within the gallbladder, after poor response to percutaneous drainage [29]. All of our patients underwent cholecystectomy and drainage of the liver abscess, preceded by a percutaneous transhepatic CT-guided drainage in the second patient that failed to successfully resolve the process.…”