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Early laparoscopic cholecystectomy in acute gallbladder perforation: Single-centre experience
Gautham Krishnamurthy1, Senthil Ganesan1, Jayapriya Ramas1
1Department of Surgical Gastroenterology, SRM Institutes for Medical Science, Chennai, Tamil Nadu, India.
Journal of Minimal Access Surgery
|March 16, 2021
Summary
Early laparoscopic cholecystectomy is a safe and feasible treatment for acute gallbladder perforation (GBP). This approach, particularly the retroinfundibular technique, effectively manages complex cases, offering a viable alternative to traditional methods.
Area of Science:
- Gastroenterology
- Surgical Innovation
- Acute Care Surgery
Background:
- Acute gallbladder perforation (GBP) presents significant mortality and morbidity risks.
- Current management often involves percutaneous drainage followed by delayed cholecystectomy.
- The efficacy of early surgical intervention, especially laparoscopic approaches, in GBP remains underexplored.
Purpose of the Study:
- To evaluate the feasibility and outcomes of early laparoscopic cholecystectomy in patients with acute gallbladder perforation.
- To assess the utility of the retroinfundibular technique in managing challenging GBP cases.
Main Methods:
- Retrospective analysis of 15 patients with acute GBP from April 2014 to December 2018.
- Review of clinical data, preoperative imaging, surgical procedures, and outcomes.
- Surgical videos were analyzed for detailed operative findings.
Main Results:
- Laparoscopic cholecystectomy was successfully completed in 12 out of 15 patients (80%).
- The retroinfundibular technique was employed in 80% of cases, proving useful for difficult dissections.
- No mortalities were recorded, with a median postoperative hospital stay of 3 days.
Conclusions:
- Early laparoscopic cholecystectomy is a safe and feasible option for acute GBP in experienced centers.
- The retroinfundibular technique is beneficial for laparoscopic management of GBP, especially in cases with a 'frozen Calot's triangle'.
