GB perforation- A surgical emergency

Abstract

Background: Gallbaldder perforation is rare but life threatening complication following acute cholecystitis. Series of events occur that leads to gallbladder perforation. Hence; the present study was undertaken for assessing the surgical management of gallbladder perforation patients. Materials & methods: The present study was conducted in the department of general surgery with the aim of assessing the surgical management of gallbladder perforation patients. Complete demographic data of all the patients was obtained. Records of all patients diagnosed to have gall bladder perforation were analysed. Ultrasonography and Abdominal computerized tomography findings of all the patients were obtained. Details of surgical treatment followed was recorded and analysed. Results: Out of 10 patients with gallbladder perforation, four patients had type I perforation, four patients had type II perforation and remaining two patients had type III perforation. Diagnosis was acute cholecystitis in 7 patients while 3 patients had peritonitis. There were 3 females while 7 males. Biliary sphincterotomy with Open cholecystectomy was carried out in 1 patient. Open cholecystectomy was done in 1 patient with type I perforation. In one patient with diagnosis of peritonitis, laparoscopic cholecystectomy was done. ERCP, Biliary sphincterotomy and Open cholecystectomy was carried out in one patient. Open cholecystectomy along with segmental resection of transverse colon was carried in two patients (type III perforation). Laparoscopic cholecystectomy, Common bile duct exploration and Choledochoduodenstomy were done in another patient. Laparoscopic cholecystectomy converted to open cholecystectomy in two patients. Conclusion: Gall bladder perforation is life threatening condition. Early diagnosis and emergency surgical treatment of gallbladder perforation is of crucial importance. If the patient is stable, then intervention after optimizing has better outcome.