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Laparoscopic management of massive intraperitoneal haemorrhage caused by an acute gallbladder perforation
Seokyoun Lee1, Jungnam Kwon1, Keunyoung Kim2
1Department of Surgery, Wonkwang University Sanbon Hospital, Wonkwang University School of Medicine, Gunpo, Korea.
Insights
Laparoscopic cholecystectomy is standard for gallstones. Acute gallbladder perforation (GP) with massive hemorrhage is rare but serious, often requiring open surgery. Laparoscopic completion cholecystectomy may be a viable option in select cases.
Area of Science:
- Gastroenterology
- Surgical Innovation
- Minimally Invasive Surgery
Background:
- Symptomatic gallstone disease is commonly treated with laparoscopic cholecystectomy.
- Acute cholecystitis can lead to gallbladder perforation (GP), a complication sometimes resulting in massive intraperitoneal hemorrhage.
- Delayed diagnosis of GP contributes to high morbidity and mortality.
Abstract:
Laparoscopic cholecystectomy is the gold standard for managing the treatment of patients with symptomatic gallstone disease. Certain patients with acute cholecystitis will develop gallbladder perforation (GP). Furthermore, massive intraperitoneal haemorrhage following perforation is a rare complication. The high morbidity and mortality rates associated with this condition are due to delays in the diagnosis and treatment since signs and symptoms of perforation do not differ significantly from those of uncomplicated cholecystitis. Severe inflammation and haemodynamic instability necessitate exploratory laparotomy in many patients. To the best of our knowledge, no study had described laparoscopic completion cholecystectomy for massive intraperitoneal haemorrhage caused by an acute GP. Laparoscopy can be an option for the management of these patients, in selected cases and with available expertise.
