Abstract

Introduction: Gallbladder perforation (GBP) is a rare & life-threatening complication of both benign & malignant diseases of the gall bladder which requires aggressive supportive management and sepsis control in the initial phase. Follow by further evaluation to know the pathology of GBP and definitive surgical management. Hence, the aim of this study is the describing an algorithmic approach based on our case series.
Material and Methods: A retrospective study of GBP patients between 2016 and 2020 in a tertiary care centre. Comparisons were made between xanthogranulomatous cholecystitis (XGC) vs. chronic cholecystitis (CC) & benign vs. malignant disease.
Results: 81 patients with GBP were included. The mean age was 54 years. Male: Female ratio was 1.13. Mortality was 3.7% (n=3). The most common clinical presentation was a combination of pain in the right upper quadrant of the abdomen & fever with chills or rigours in 61(75.3%) cases. Surgery was performed in 62 patients (76.5%) out of which, open cholecystectomy 23 (37.7%) was the most common. 7 had the malignant disease in the final histopathology. The most common aetiology was XGC – 32 (51.61%).
Conclusions: GBP is a complex problem, requiring multidisciplinary aggressive management in the initial phase followed by meticulous evaluation before definitive surgery.

Key words: Gall bladder perforation, Xanthogranulomatous cholecystitis, Chronic cholecystitis, Subtotal cholecystectomy, Carcinoma gall bladder