Gallbladder perforation: morbidity, mortality and preoperative risk prediction

Ausania, Fabio; Suárez, Silvia Guzmán; Garcia, Heriberto; Rı́o, Paula; Núñez, Enrique

doi:10.1007/s00464-014-3765-6

Cited by 42 publications

(44 citation statements)

References 25 publications

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“…3 Mortality can be high (12-16%), with one case series reporting a prevalence of 42%. 4 Low preoperative albumin levels, open surgery and preoperative sepsis are associated with complications.…”

Section: Discussionmentioning

confidence: 99%

“…4 Low preoperative albumin levels, open surgery and preoperative sepsis are associated with complications. 3 Preoperative sepsis is independently associated with in-hospital mortality. 3 Gallbladder perforations were classified into three types by Niemeier in 1934: 1, acute generalised peritonitis; 2, subacute formation of abscesses; 3, chronic perforations with a fistulous communication.…”

Section: Discussionmentioning

confidence: 99%

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Perfoation of the gallbladder: ‘bait’ for the unsuspecting laparoscopic surgeon

Mughal

Green

et al. 2017

annals

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INTRODUCTION Cholecystectomy is one of the most common elective procedures carried out by general surgeons. Most patients present with typical biliary anatomy and simple gallstone disease. Intraoperative and postoperative courses are frequently predictable and uncomplicated. Nevertheless, a small but significant number of patients experience complicated disease with rare presentations and complex biliary anatomy. Unfortunately, consensus on appropriate care for such patients is lacking. CASE HISTORY We describe three patients who presented with complex manifestations of gallbladder perforation: acute perforation of the gallbladder; a spontaneous cholecystocutaneous fistula; a cholecystoduodenal fistula. The initial presentation, preoperative investigations, and selected surgical strategy for each case are described. CONCLUSIONS The case studies described here illustrate the need for a low index of suspicion for gallbladder perforation. Caution should be exercised in preoperative and intraoperative phases in this patient population.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Perfoation of the gallbladder: ‘bait’ for the unsuspecting laparoscopic surgeon

Mughal

Green

et al. 2017

annals

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“…In December 2015, a 40-year-old man with a 10-year history of calculus cholecystitis was referred to The First Affiliated Hospital of Nanjing Medical University (Nanjing, China) for A giant and insidious subphrenic biloma formation due to gallbladder perforation mimicking biliary cystic tumor: A case report 4.0 ng/ml; carbohydrate antigen 19-9, 0.7 U/ml) were all within normal limits.…”

Section: Case Reportmentioning

confidence: 99%

“…Gallbladder perforation (GBP) represents a rare, but potentially life-threatening, complication of acute cholecystitis, with an incidence rate of 0.8-4.8% and a mortality rate of 9.5-16% as reported in recent studies (1)(2)(3)(4). The proposed mechanism of GBP is gallbladder wall ischemia and necrosis triggered by intense inflammatory reaction, and intracholecystic hypertension caused by calculi impacted in the cystic duct (5).…”

Section: Introductionmentioning

confidence: 99%

A giant and insidious subphrenic biloma formation due to gallbladder perforation mimicking biliary cystic tumor: A case report

Zhu

Wang

Jiao

et al. 2016

Molecular and Clinical Oncology

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Abstract. Gallbladder perforation (GBP) represents a rare, but potentially life-threatening, complication of acute cholecystitis. GBP is subdivided into three categories whereas the development of biloma is extremely rare. The present case study reports on a 40-year-old man with a 10-year history of calculus cholecystitis, who was referred to The First Affiliated Hospital of Nanjing Medical University (Nanjing, China) for the surgical treatment of an emerging massive hepatic entity with insidious symptoms and normal laboratory tests. A preoperative imaging study demonstrated the collection with internal septations and mural nodules, but no visible communication with the biliary system. Given the suspected biliary cystic tumor, a laparotomy was performed and the lumen was scattered with papillae. An intraoperative frozen section examination illustrated a simple hepatic cyst. Biochemical analysis of the collection and histopathology of the gallbladder and capsule substantiated the diagnosis of biloma formation due to GBP. The purpose of the present case report was to demonstrate how a pinhole-sized perforation with extravasation of unconcentrated bile from the gallbladder may result in insidious clinical presentation and an undetected leak site. According to the clinicopathological characteristics and composition, formation of biloma should be classified as type IV GBP. To differentiate bilomas with intracystic septations and mural nodules from BCTs is difficult via a preoperative examination, and the definitive diagnosis should be based on a histological examination. Laparotomy with frozen section examination may be the optimal approach in such a case.

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“…It has high morbidity and mortality rates due to the difficulty of early diagnosis (1). While the management of acute cholecystitis is easy in case of early diagnosis and intervention, it can evolve to a much more complicated condition such as perforation of gallbladder if the diagnosis is missed and the intervention is delayed.…”

Section: Introductionmentioning

confidence: 99%

A Series of Five Complicated Cases with Gallbladder Perforation due to Acute Cholecystitis

Yılmaz¹,

Soyder²,

Bilgiç³

et al. 2018

meandros

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Gallbladder perforation is one of the rarely feared complications of acute cholecystitis. It is usually not seen very often, but it is seen in 10% (2-20). Despite radiological progresses, morbidity and mortality are high due to late diagnosis. The time of diagnosis and the general condition of the patient during diagnosis are very likely to affect mortality, so you have to be careful in these cases. Because it is a rare complication, it is not the first diagnosis that comes to mind in the preliminary diagnoses in the case of acute abdomen in cases of emergency. In this article we will present a series of complicated cases from the emergency department with gallbladder perforation. We would like to emphasize that gallbladder perforation with this case series presentation should be one of the diagnoses that should be kept in mind in emergency patients.

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Gallbladder perforation: morbidity, mortality and preoperative risk prediction

Abstract: Preoperative severe sepsis is the most important factor associated with postoperative morbidity and mortality following GBP, and it can be helpful to identify those patients needing the highest level of care possible.

Cited by 42 publications

References 25 publications

Perfoation of the gallbladder: ‘bait’ for the unsuspecting laparoscopic surgeon

Perfoation of the gallbladder: ‘bait’ for the unsuspecting laparoscopic surgeon

A giant and insidious subphrenic biloma formation due to gallbladder perforation mimicking biliary cystic tumor: A case report

A Series of Five Complicated Cases with Gallbladder Perforation due to Acute Cholecystitis

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