Surgical and non-surgical treatment of non-traumatic gallbladder perforation

Objective

Our aim was to present a single-center experience in the management of gallbladder perforation (GBP).

Patients and methods

Adult patients who had GBP were managed surgically and percutaneously. Patients who were high risk surgical candidates or who refused surgery were managed by image guided percutaneous drainage.

Results

Thirty-seven patients (21 males, 16 females) with an average age of 64 ± 14 years had GBP. The number of patients with GBP type I, II, and III were 13, 21, and 3, respectively. All GBP types I and III patients were treated surgically. Eleven of GBP type II patients were treated surgically, and 10 were treated by percutaneous catheter drainage. The overall mortality rate was 27% (10/37). No procedure-related mortality rate among those patients who were treated percutaneously; however, 30 days post procedure, the mortality rate was 30%. All of these deaths were related to the patients’ comorbidities; none of them was due to septicemia but conversely in surgically treated patients, 5 died due to septicemia (3 in GBP type I and 2 in GBP type II) in the postoperative period and one patient died because of severe internal hemorrhage complicating acute pancreatitis and one patient died few months later because of myocardial infarction.

Conclusion

Surgery is the cornerstone of treatment for all types of GBP. Percutaneous catheter drainage is a safe and effective option for treating patients with localized disease with favorable outcome.