Early laparoscopic cholecystectomy in acute gallbladder perforation: Single-centre experience
| Autor: | Jayapriya Ramas, Karthikeyan Damodaran, Senthil Ganesan, Gautham Krishnamurthy, Radhakrishna Patta, Aswin Khanna |
|---|---|
| Jazyk: | angličtina |
| Rok vydání: | 2021 |
| Předmět: |
medicine.medical_specialty
Percutaneous retroinfundibular medicine.medical_treatment Perforation (oil well) lcsh:Surgery Cystic artery Gallbladder perforation 03 medical and health sciences 0302 clinical medicine medicine.artery Medicine acute cholecystitis lcsh:RC799-869 Laparoscopy gallbladder perforation laparoscopic cholecystectomy medicine.diagnostic_test business.industry Bile duct Gallbladder lcsh:RD1-811 Surgery medicine.anatomical_structure 030220 oncology & carcinogenesis subtotal cholecystectomy Original Article 030211 gastroenterology & hepatology Cholecystectomy lcsh:Diseases of the digestive system. Gastroenterology business |
| Zdroj: | Journal of Minimal Access Surgery, Vol 17, Iss 2, Pp 153-158 (2021) Journal of Minimal Access Surgery |
| ISSN: | 1998-3921 0972-9941 |
| Popis: | Background: Acute gallbladder perforation (GBP) is associated with significant mortality and morbidity. Percutaneous drainage followed by interval cholecystectomy has been the preferred management. The outcomes of early surgery, especially by laparoscopy, have not been well studied in GBP. We present our experience in early laparoscopic cholecystectomy in GBP. Methodology: A retrospective analysis of patients admitted with GBP between April 2014 and December 2018 was done. Clinical presentation, preoperative imaging, surgical procedure, operative findings and the outcomes in these patients were analysed. Video of the surgeries was reviewed in case of the absence of data from the case records. Results: Fifteen patients were treated for GBP during the study period. Eleven patients were male, and the mean age was 61 years. Fourteen patients (93.3%) had associated co-morbidities. Systemic inflammatory response syndrome, sepsis, severe sepsis and septic shock were present in 3, 3, 6 and 3 patients, respectively. The location of the collection was gallbladder fossa, pericholecystic, subhepatic and diffuse in 3, 5, 4 and 3 patients, respectively. Intraoperatively, 13 patients were detected to have perforation at the fundus of the gallbladder. Cystic duct stump was managed with clip, endoloop, suturing and external drainage in 7, 2, 5 and 1 patient, respectively. Laparoscopic cholecystectomy was completed in 12 (80%) patients. Retroinfundibular technique was used in 12 (80%) patients. There was one conversion. Two patients required endoscopic retrograde cholangiogram + bile duct stenting, and one was reexplored for cystic artery bleed. There were no mortalities. The median duration of post-operative hospital stay and drain removal was 3 (1–19) and 3 (1–6), respectively. Conclusion: Early laparoscopic cholecystectomy in acute GBP is feasible and can be safely performed in centres having sufficient expertise. Retroinfundibular technique of laparoscopic cholecystectomy is useful in tackling frozen Calot's triangle in GBP. |
| Databáze: | OpenAIRE |
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