ACUTE EMPHYSEMATOUS CHOLECYSTITIS WITH PNEUMOBILIA: A CASE MANAGED BY LAPAROSCOPIC CHOLECYSTECTOMY FOLLOWING PERCUTANEOUS TRANSHEPATIC GALLBLADDER DRAINAGE

Abstract

Acute emphysematous cholecystitis is a serious disorder with high mortality and morbidity. We report a case of emphysematous cholecystitis with pneumobilia managed by laparoscopic cholecystectomy (LC) following percutaneous transhepatic gallbladder drainage (PTGBD). A 63-year-old woman was admitted with a chief complaint of the right hypochondralgia and diagnosed as acute cholecystitis. Gall stones and thicking of the gall bladder wall was detected by ultrasonography (US). On the third day after admission, the presence of gas in the gall bladder and biliary tract was detected by US, plain abdominal X-ray and CT scan. The patient appeared clinically unwell, so PTGBD was carried out. Cholangiography after PTGBD showed a remarkable stenosis of the common bile duct. On the 6 th day after PTGBD, laparoscopic cholecystectomy was performed. The postoperative course was good and the patient was discharged on the 14 th day after surgery. We consider PTGBD and LC useful procedures for treating acute emphysematous cholecystitis.