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Quiroga-Garza A, Alvarez-Villalobos NA, Muñoz-Leija MA, Garcia-Campa M, Angeles-Mar HJ, Jacobo-Baca G, Elizondo-Omana RE, Guzman-Lopez S. Gallbladder perforation with fistulous communication. World J Gastrointest Surg 2023; 15:1191-1201. [PMID: 37405089 PMCID: PMC10315112 DOI: 10.4240/wjgs.v15.i6.1191] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/20/2023] [Revised: 02/17/2023] [Accepted: 04/19/2023] [Indexed: 06/15/2023] Open
Abstract
BACKGROUND The management of gallbladder perforation (GBP) with fistulous communication (Neimeier type I) is controversial.
AIM To recommend management options for GBP with fistulous communication.
METHODS A systematic review of studies describing the management of Neimeier type I GBP was performed according to the PRISMA guidelines. The search strategy was conducted in Scopus, Web of Science, MEDLINE, and EMBASE (May 2022). Data extraction was obtained for patient characteristics, type of intervention, days of hospitalization (DoH), complications, and site of fistulous communication.
RESULTS A total of 54 patients (61% female) from case reports, series, and cohorts were included. The most frequent fistulous communication occurred in the abdominal wall. Patients from case reports/series had a similar proportion of complications between open cholecystectomy (OC) and laparoscopic cholecystectomy (LC) (28.6 vs 12.5; P = 0.569). Mortality was higher in OC (14.3 vs 0.0; P = 0.467) but this proportion was given by only one patient. DoH were higher in OC (mean 26.3 d vs 6.6 d). There was no clear association between higher rates of complications of a given intervention in cohorts, and no mortality was observed.
CONCLUSION Surgeons must evaluate the advantages and disadvantages of the therapeutic options. OC and LC are adequate options for the surgical management of GBP, with no significant differences.
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Affiliation(s)
- Alejandro Quiroga-Garza
- Human Anatomy Department, Universidad Autonoma de Nuevo Leon, School of Medicine, Monterrey 64460, Nuevo Leon, Mexico
- General Surgery Division, Hospital de Traumatología y Ortopedia No. 21, Instituto Mexicano del Seguro Social, Monterrey 64000, Nuevo Leon, Mexico
| | - Neri Alejandro Alvarez-Villalobos
- Plataforma INVEST Medicina UANL-KER Unit Mayo Clinic, Universidad Autonoma de Nuevo Leon, School of Medicine, Monterrey 64460, Nuevo Leon, Mexico
- Family Medicine Division, Instituto Mexicano del Seguro Social, Monterrey 64000, Nuevo Leon, Mexico
| | - Milton Alberto Muñoz-Leija
- Human Anatomy Department, Universidad Autonoma de Nuevo Leon, School of Medicine, Monterrey 64460, Nuevo Leon, Mexico
- Surgery Division, Hospital General de Zona No. 6, Instituto Mexicano del Seguro Social, Monterrey 64000, Nuevo Leon, Mexico
| | - Mariano Garcia-Campa
- Plataforma INVEST Medicina UANL-KER Unit Mayo Clinic, Universidad Autonoma de Nuevo Leon, School of Medicine, Monterrey 64460, Nuevo Leon, Mexico
| | - Hermilo Jeptef Angeles-Mar
- Human Anatomy Department, Universidad Autonoma de Nuevo Leon, School of Medicine, Monterrey 64460, Nuevo Leon, Mexico
| | - Guillermo Jacobo-Baca
- Human Anatomy Department, Universidad Autonoma de Nuevo Leon, School of Medicine, Monterrey 64460, Nuevo Leon, Mexico
| | | | - Santos Guzman-Lopez
- Human Anatomy Department, Universidad Autonoma de Nuevo Leon, School of Medicine, Monterrey 64460, Nuevo Leon, Mexico
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Yadav SK, Thakur M, Dhiman A, Kumar A, Sharma G. Giant Gallstone With Gallbladder Perforation and Hepatic Abscess in an Asian Patient. Cureus 2023; 15:e39894. [PMID: 37404388 PMCID: PMC10315686 DOI: 10.7759/cureus.39894] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/02/2023] [Indexed: 07/06/2023] Open
Abstract
Giant gallstone with a secondary hepatic abscess is a very rare phenomenon. We recently treated a patient with a giant gallbladder (GB) stone of size 11.5 cm with a hepatic abscess who presented with features of an acute abdomen. This was subsequently managed with an open subtotal cholecystectomy and concomitant hepatic abscess drainage. To the best of our knowledge and after a thorough literature search, this is one of the largest reported gall bladder (GB) stones with wall perforation and hepatic abscess in the Asian subcontinent.
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Affiliation(s)
- Saroj K Yadav
- Department of General Surgery, All India Institute of Medical Sciences, Bilaspur, Bilaspur, IND
| | - Mohim Thakur
- Department of General Surgery, All India Institute of Medical Sciences, Bilaspur, Bilaspur, IND
| | - Ajay Dhiman
- Department of General Surgery, All India Institute of Medical Sciences, Bilaspur, Bilaspur, IND
| | - Ajeet Kumar
- Department of General Surgery, All India Institute of Medical Sciences, Bilaspur, Bilaspur, IND
| | - Gopal Sharma
- Department of Radiology, All India Institute of Medical Sciences, Bilaspur, Bilaspur, IND
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Saleem A, Almutairi M, Hassan A, Al-Shadidi N, Alshammari K. Cholecysto-hepatic fistula in type III gallbladder perforation: A rare etiology of liver abscess; case report. Int J Surg Case Rep 2023; 105:108002. [PMID: 36965442 PMCID: PMC10073879 DOI: 10.1016/j.ijscr.2023.108002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2022] [Revised: 03/14/2023] [Accepted: 03/17/2023] [Indexed: 03/27/2023] Open
Abstract
INTRODUCTION AND IMPORTANCE Gallbladder perforation (GBP) with cholecystohepatic fistula is an extremely rare complication of acute and/or chronic gallbladder diseases. Niemeier classified GBP into three types each characterized by specific signs and symptoms. Radiological investigations such as abdominal ultrasonography (USG) and computed tomography (CT) are crucial to evaluate and diagnosing GBP, while fistulae are usually identified intraoperatively. CASE PRESENTATION A 77-year-old female patient, with a background medical history of multiple comorbidities, presented to our hospital with a one-week history of abdominal pain. Laboratory investigations showed abnormal values. The abdominal CT scan revealed a mildly enlarged liver, distended gallbladder, and liver abscess. Then, ultrasound-guided aspiration was done, and the clinical picture was consistent with calcular cholecystitis complicated with liver abscess. So, laparoscopic cholecystectomy was decided and the intraoperatively detected fistula was excised. The resected perforated gallbladder was sent for histopathological studies. The postoperative period was uneventful. CLINICAL DISCUSSION GBP is an unusual entity that is categorized into three types. It is considered a gallbladder complication and surgical emergency. The clinical features of GBP are non-specific and radiological tools aid in diagnosis demonstration. In the presented case of type III GBP, cholecystohepatic fistula was detected and excised intraoperatively. CONCLUSION Due to the rare entity of type III GBP in association with liver abscess, we report the case of a 77-year-old female with right lower quadrant pain, found to be caused by type III GBP with cholecystohepatic fistula and liver abscess.
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Affiliation(s)
- Athary Saleem
- Department of General Surgery, Al-Adan Hospital, Kuwait.
| | | | - Ahmed Hassan
- Department of General Surgery, Al-Adan Hospital, Kuwait
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Baier AS, Liu D, Yee J, Cherng N, Cui H, Kim E. Emergent laparoscopic surgical intervention for perforated hemorrhagic cholecystitis with hemodynamic instability. J Surg Case Rep 2022; 2022:rjac454. [PMID: 36285168 PMCID: PMC9581507 DOI: 10.1093/jscr/rjac454] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2022] [Accepted: 09/07/2022] [Indexed: 12/02/2022] Open
Abstract
Hemorrhagic cholecystitis is a rare diagnosis that closely mimics acute cholecystitis. Physical examination, laboratory studies and, in particular, computed tomography imaging allow for rapid diagnosis, stabilization and emergent surgical intervention. We describe our experience with three patients requiring emergent surgical intervention for hemorrhagic cholecystitis with unique clinical features including decreased platelet function due to liver cirrhosis, dual antiplatelet therapy and intraoperative finding of cholecystohepatic communication. Furthermore, we provide video recordings of two cases highlighting the severity of the disease. All presented patients were hemodynamically unstable and showed peritoneal signs on exam. Laboratory studies revealed moderate anemia and leukocytosis, while computed tomography suggested hemorrhage in the gallbladder. All patients required blood transfusions during their care and underwent laparoscopic cholecystectomy. Hemoperitoneum and gallbladder perforation were confirmed intraoperatively. Patients fully recovered without significant postoperative complications due to expedited operative management.
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Affiliation(s)
| | - Dorothy Liu
- Department of Surgery, University of Massachusetts Memorial Medical Center, Worcester, MA, USA
| | - Jonson Yee
- Department of Surgery, University of Massachusetts Memorial Medical Center, Worcester, MA, USA
| | - Nicole Cherng
- Department of Surgery, University of Massachusetts Memorial Medical Center, Worcester, MA, USA
| | - Hongyi Cui
- Department of Surgery, University of Massachusetts Memorial Medical Center, Worcester, MA, USA
| | - Edward Kim
- Correspondence address. Department of Surgery, University of Massachusetts Memorial Medical Center, 55 Lake Avenue North, Worcester, MA 01655, USA. Tel: 508-856-3744; E-mail:
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Gupta V, Chandra A, Gupta V, Patel R, Dangi A, Pai A. Gallbladder perforation: A single-center experience in north India and a step-up approach for management. Hepatobiliary Pancreat Dis Int 2022; 21:168-174. [PMID: 34548226 DOI: 10.1016/j.hbpd.2021.08.011] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/25/2020] [Accepted: 08/24/2021] [Indexed: 02/05/2023]
Abstract
BACKGROUND Spontaneous gallbladder perforation (GBP) is an uncommon diagnosis. This study presented the experience of managing spontaneous GBP over nine years at a large, tertiary care university hospital in north India and investigated the outcomes and treatment strategies. METHODS A retrospective review of prospectively maintained digital database of consecutive patients was performed. All patients received medical and/or surgical treatment for spontaneous GBP in our department between January 2010 and June 2018. RESULTS We identified 151 patients (81 females and 70 males) with mean age of 53 years. Most common presenting features were pain (96.7%), fever (54.3%) and jaundice (31.1%). Most common cause was gallbladder stones (84.8%) followed by common bile duct stones (30.5%), xanthogranulomatous cholecystitis (17.9%) and malignancy (11.9%). As per Niemeier classification, 8.6% had type 1 GBP (free perforation in peritoneal cavity), 76.2% had type 2 GBP (localized perforation) and 13.2% had type 3 GBP (cholecysto-enteric fistula). About 60% of the perforations were diagnosed preoperatively. Type 1 was more common in patients with diabetes and also had the worst prognosis. Surgery was performed in 109 patients (72.2%). Seven patients (4.6%) had a postoperative morbidity of Clavien-Dindo III or higher. There were three mortalities in patients who underwent surgery. CONCLUSIONS High index of suspicion is required for preoperative diagnosis of GBP, especially in types 2 and 3. Laparoscopic cholecystectomy can be difficult in these patients and patients may require open or partial cholecystectomy. Early diagnosis and step-up approach for the treatment of GBP is critical.
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Affiliation(s)
- Vivek Gupta
- Department of Surgical Gastroenterology, King George's Medical University, Lucknow, Uttar Pradesh 226003, India
| | - Abhijit Chandra
- Department of Surgical Gastroenterology, King George's Medical University, Lucknow, Uttar Pradesh 226003, India.
| | - Vishal Gupta
- Department of Surgical Gastroenterology, King George's Medical University, Lucknow, Uttar Pradesh 226003, India
| | - Ravi Patel
- Department of Surgical Gastroenterology, King George's Medical University, Lucknow, Uttar Pradesh 226003, India
| | - Amit Dangi
- Department of Surgical Gastroenterology, King George's Medical University, Lucknow, Uttar Pradesh 226003, India
| | - Ajay Pai
- Department of Surgical Gastroenterology, King George's Medical University, Lucknow, Uttar Pradesh 226003, India
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Quiroga-Garza A, Alvarez-Villalobos NA, Angeles-Mar HJ, Garcia-Campa M, Muñoz-Leija MA, Salinas-Alvarez Y, Elizondo-Omaña RE, Guzmán-López S. Localized gallbladder perforation: a systematic review of treatment and prognosis. HPB (Oxford) 2021; 23:1639-1646. [PMID: 34246546 DOI: 10.1016/j.hpb.2021.06.003] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/17/2021] [Revised: 05/27/2021] [Accepted: 06/03/2021] [Indexed: 12/12/2022]
Abstract
BACKGROUND The optimal management of localized gallbladder perforation (Neimeier type II) has yet to be defined. The aim of this systematic review was to identify factors associated with improved patient outcomes. METHODS Systematic review of studies that described the management of Neimeier type II perforation, reported complications of the first intervention, necessity of added interventions, resolution of the pathology, and days of hospital stay were included. The search strategy was conducted in EMBASE, Mayo Journals, MEDLINE, SCOPUS, and Web of Science (December 2020) RESULTS: A total of 122 patients (53% male) from case reports, series, and cohorts were included for analysis. In total 56 (46%) and 44 (36%)patients were treated with open and laparoscopic cholecystectomy respectively. Overall risk of bias was moderate. The need for another intervention was higher in the laparoscopic group (5 vs 17, p=<0.001) as well as prevalence of complications (4 vs 16, p=<0.001), but lower for days of hospital stay (median days 5. vs 15, p = 0.008) against open cholecystectomy. Preoperative percutaneous catheter drainage did not influence outcome. CONCLUSION Open cholecystectomy has a lower need for further surgical procedures and postoperative complications, but a longer hospital stay. These outcomes did not vary with preoperative percutaneous drainage. The effect of timing of cholecystectomy did not influence the outcomes.
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Affiliation(s)
- Alejandro Quiroga-Garza
- Universidad Autónoma de Nuevo León, School of Medicine, Human Anatomy Department, Mexico; Instituto Mexicano Del Seguro Social, Delegación Nuevo Leon, Monterrey, Mexico
| | - Neri A Alvarez-Villalobos
- Instituto Mexicano Del Seguro Social, Delegación Nuevo Leon, Monterrey, Mexico; Universidad Autónoma de Nuevo León, School of Medicine, Plataforma INVEST Medicina UANL-KER Unit Mayo Clinic (KER Unit México), Mexico
| | - Hermilo J Angeles-Mar
- Universidad Autónoma de Nuevo León, School of Medicine, Human Anatomy Department, Mexico
| | - Mariano Garcia-Campa
- Universidad Autónoma de Nuevo León, School of Medicine, Plataforma INVEST Medicina UANL-KER Unit Mayo Clinic (KER Unit México), Mexico
| | - Milton A Muñoz-Leija
- Universidad Autónoma de Nuevo León, School of Medicine, Human Anatomy Department, Mexico
| | | | | | - Santos Guzmán-López
- Universidad Autónoma de Nuevo León, School of Medicine, Human Anatomy Department, Mexico.
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Chikamori F, Yukishige S, Ueta K, Takasugi H, Mizobuchi K, Matsuoka H, Hokimoto N, Yamai H, Onishi K, Tanida N, Hamaguchi N, Iwasaki T. Hemoperitoneum and sepsis from transhepatic gallbladder perforation of acute cholecystitis: A case report. Radiol Case Rep 2020; 15:2241-2245. [PMID: 32952763 PMCID: PMC7486689 DOI: 10.1016/j.radcr.2020.08.064] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2020] [Revised: 08/28/2020] [Accepted: 08/30/2020] [Indexed: 11/05/2022] Open
Abstract
We report a case of hemoperitoneum and sepsis from transhepatic gallbladder perforation in an 87-year-old male with acute cholecystitis who had past history of endoscopic sphincterotomy for common bile duct stone. Contrast-enhanced computed tomography (CT) showed intrahepatic and subcapsular low density areas. A wall defect of gallbladder was seen in coronal and sagittal - sections at the liver bed. Fluids obtained through the paracentesis were hemorrhagic. Percutaneous transhepatic gallbladder drainage (PTGBD) was attempted. First cholangiography revealed an orifice of fistula. Further injection of contrast medium drained into the intrahepatic secondary abscess and intraperitoneal cavity confirming the diagnosis of transhepatic gallbladder perforation. We conclude that contrast-enhanced CT with coronal and sagittal - sections and cholangiography via PTGBD tube are useful to confirm diagnosis of transhepatic gallbladder perforation.
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Affiliation(s)
- Fumio Chikamori
- Department of Surgery, Japanese Red Cross Kochi Hospital, Kochi, Japan
| | - Sawaka Yukishige
- Department of Surgery, Japanese Red Cross Kochi Hospital, Kochi, Japan
| | - Koji Ueta
- Department of Surgery, Japanese Red Cross Kochi Hospital, Kochi, Japan
| | - Haruka Takasugi
- Department of Surgery, Japanese Red Cross Kochi Hospital, Kochi, Japan
| | - Kai Mizobuchi
- Department of Surgery, Japanese Red Cross Kochi Hospital, Kochi, Japan
| | - Hisashi Matsuoka
- Department of Surgery, Japanese Red Cross Kochi Hospital, Kochi, Japan
| | - Norihiro Hokimoto
- Department of Surgery, Japanese Red Cross Kochi Hospital, Kochi, Japan
| | - Hiromichi Yamai
- Department of Surgery, Japanese Red Cross Kochi Hospital, Kochi, Japan
| | - Kazuhisa Onishi
- Department of Surgery, Japanese Red Cross Kochi Hospital, Kochi, Japan
| | - Nobuyuki Tanida
- Department of Surgery, Japanese Red Cross Kochi Hospital, Kochi, Japan
| | | | - Takehiro Iwasaki
- Department of Gastroenterology, Japanese Red Cross Kochi Hospital, Kochi, Japan
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Abstract
Intra-hepatic perforation of the gallbladder (GB) leading to hepatic abscess is a serious and rare complication of cholecystitis, with very few sporadically reported cases in the literature. Hence, there is no standard approach to treat it. A thorough radiological evaluation with computed tomography and endoscopic retrograde cholangiopancreatography is necessary before proceeding with surgery in such cases. An early laparoscopic intervention to perform a sub-total cholecystectomy with drain placement is enough to treat both cholecystitis and liver abscess in a definitive manner. While previous reports have advocated an open surgery, our series demonstrates that early laparoscopic management is a safe and suitable approach in such cases.
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Affiliation(s)
- Tejas Nikumbh
- Department of Surgery, Grant Medical College and Sir JJ Group of Hospitals, Mumbai, Maharashtra, India
| | - Ajay Bhandarwar
- Department of Surgery, Grant Medical College and Sir JJ Group of Hospitals, Mumbai, Maharashtra, India
| | - Shubhangi Sanap
- Department of Surgery, Grant Medical College and Sir JJ Group of Hospitals, Mumbai, Maharashtra, India
| | - Gajanan Wagholikar
- Deenanath Mangeshkar Hospital and Research Centre, Pune, Maharashtra, India
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9
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Lan X, Xiang Y, Liu F, Li B, Wei Y, Zhang H. Massive hemoperitoneum and upper gastrointestinal hemorrhage following liver rupture secondary to gallbladder perforation: A case report and literature review. Medicine (Baltimore) 2019; 98:e14729. [PMID: 30882639 PMCID: PMC6426586 DOI: 10.1097/md.0000000000014729] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/05/2023] Open
Abstract
RATIONALE Available literature states that the common reasons for non-traumatic spontaneous liver rupture are hepatocellular carcinoma, macronodular cirrhosis, hemangioma, and other tumors; gallbladder perforation is not cited as a cause. PATIENT CONCERNS The patient presented with sudden-onset right upper quadrant pain with tarry stool for 3 days after eating with dysphoria and increasing thirst; gradually, hemorrhagic shock developed. He had no history of trauma, no background of chronic hepatitis, and no cirrhosis. DIAGNOSIS Hemorrhage secondary to spontaneous rupture of intrahepatic cholangiocarcinoma. INTERVENTIONS Left hemihepatectomy, cholecystectomy, and common bile duct exploration were performed. OUTCOMES The patient was diagnosed with massive hemoperitoneum accompanying upper gastrointestinal hemorrhage following liver rupture secondary to gallbladder perforation. The postoperative course was uneventful and the patient was discharged after 10 days of hospitalization. LESSONS If patients present with non-traumatic spontaneous liver rapture accompanying cholelithiasis and gallbladder hematoma, gallbladder perforation should be considered as a differential diagnosis. Misdiagnosis can lead to incorrect treatment.
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Affiliation(s)
- Xiang Lan
- Department of Liver Surgery & Liver Transplantation Center, West China Hospital of Sichuan University, Chendu, Sichuan
| | - Yuanyuan Xiang
- Department of Digestive Disease Center, The Third Affiliated Hospital of Chongqing Medical University, Chongqing, People's Republic of China
| | - Fei Liu
- Department of Liver Surgery & Liver Transplantation Center, West China Hospital of Sichuan University, Chendu, Sichuan
| | - Bo Li
- Department of Liver Surgery & Liver Transplantation Center, West China Hospital of Sichuan University, Chendu, Sichuan
| | - Yonggang Wei
- Department of Liver Surgery & Liver Transplantation Center, West China Hospital of Sichuan University, Chendu, Sichuan
| | - Hua Zhang
- Department of Liver Surgery & Liver Transplantation Center, West China Hospital of Sichuan University, Chendu, Sichuan
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Williams P, Dosani A, Morgan-Jones R. Endoscopic cystic duct stent as primary treatment for intrahepatic gallbladder perforation with abscess formation. Ann R Coll Surg Engl 2017; 99:e118-e120. [PMID: 28349752 DOI: 10.1308/rcsann.2017.0047] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Intrahepatic gallbladder perforation with abscess formation is an uncommon presentation of biliary disease. There is no consensus on how to treat this condition, with strategies varying from percutaneous drainage to open cholecystectomy and washout. We present a case of a novel, minimally invasive treatment, using endoscopic retrograde cholangiopancreatography to place a transcystic drain as a bridge to laparoscopic cholecystectomy.
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Affiliation(s)
- P Williams
- Freeman Hospital, Hepatobiliary and Pancreatic Surgery, Newcastle upon Tyne , UK
| | - A Dosani
- Freeman Hospital, Hepatobiliary and Pancreatic Surgery, Newcastle upon Tyne , UK
| | - R Morgan-Jones
- Freeman Hospital, Hepatobiliary and Pancreatic Surgery, Newcastle upon Tyne , UK
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Abusedera MA, Khaliel M, Hassan AEM. Surgical and non-surgical treatment of non-traumatic gallbladder perforation. The Egyptian Journal of Radiology and Nuclear Medicine 2017; 48:43-9. [DOI: 10.1016/j.ejrnm.2016.10.005] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/24/2023] Open
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