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World J Gastroenterol. Dec 28, 2006; 12(48): 7832-7836
Published online Dec 28, 2006. doi: 10.3748/wjg.v12.i48.7832
Diagnosis and treatment of gallbladder perforation
Hayrullah Derici, Cemal Kara, Ali Dogan Bozdag, Okay Nazli, Tugrul Tansug, Esra Akca
Hayrullah Derici, Cemal Kara, Ali Dogan Bozdag, Okay Nazli, Tugrul Tansug, Esra Akca, Third Surgical Clinic of Atatürk Training and Research Hospital, Izmir 35360, Turkey
Correspondence to: Dr. Hayrullah Derici, Third Surgical Clinic of Atatürk Training and Research Hospital, 156 sok. No. 5/13 Bornova, Izmir 35360, Turkey. hayrullahderici@yahoo.com
Telephone: +90-232-3747899 Fax: +90-232-4632786
Received: September 6, 2006
Revised: September 28, 2006
Accepted: November 7, 2006
Published online: December 28, 2006
Abstract

AIM: To present our clinical experience with gallbladder perforation cases.

METHODS: Records of 332 patients who received medical and/or surgical treatment with the diagnosis of acute cholecystitis in our clinic between 1997 and 2006 were reviewed retrospectively. Sixteen (4.8%) of those patients had gallbladder perforation. The parameters including age, gender, time from the onset of symptoms to the time of surgery, diagnostic procedures, surgical treatment, morbidity, and mortality were evaluated.

RESULTS: Seven patients had typeIgallbladder perforation, 7 type II gallbladder perforation, and 2 type III gallbladder perforation according to Niemeier’s classification. The patients underwent surgery after administration of intravenous electrolyte solutions, and were treated with analgesics and antibiotics within the first 36 h (mean 9 h) after admission. Two patients died of sepsis and multiple organ failure in the early postoperative period. Subhepatic abscess, pelvic abscess, pneumonia, pancreatitis, and acute renal failure were found in 6 patients.

CONCLUSION: Early diagnosis and emergency surgical treatment of gallbladder perforation are of crucial importance. Upper abdominal computerized tomography for acute cholecystitis patients may contribute to the preoperative diagnosis of gallbladder perforation.

Keywords: Acute cholecystitis; Gallbladder perforation; Early diagnosis; Computed tomography; Emergency surgery