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Laparoscopic cholecystectomy after open cholecystostomy for gallbladder empyema: a case report
Evangelos P Misiakos1, Gabriel Karatzas, Anastasios Macheras
13rd Department of Surgery, University of Athens School of Medicine, Attikon University Hospital, Athens, Greece. misiakos@med.uoa.gr
Summary
Gallbladder empyema was initially managed with tube cholecystostomy. A subsequent interval laparoscopic cholecystectomy was successfully performed eight weeks later, demonstrating a safe and effective treatment approach.
Area of Science:
- Gastroenterology and Hepatobiliary Surgery
Background:
- Gallbladder empyema necessitates prompt management, often involving drainage.
- Minilaparotomy with tube cholecystostomy offers initial decompression under local anesthesia.
Observation:
- A patient with gallbladder empyema underwent initial drainage via tube cholecystostomy.
- Adhesions formed between the gallbladder, abdominal wall, and omentum around the drainage tube.
Findings:
- Eight weeks post-drainage, an elective interval laparoscopic cholecystectomy was performed.
- The gallbladder and cholecystostomy tube were successfully dissected free laparoscopically.
- The procedure was completed without significant complications.
Implications:
- Interval laparoscopic cholecystectomy is a feasible option after initial tube drainage for gallbladder empyema.
- This approach may reduce operative complexity and patient morbidity.
- Careful dissection is required to manage adhesions in interval laparoscopic procedures.
