Laporoscopic Cholecystectomy in Empyma, pus in gall bladder (VIDEO)


The laparoscopic cholecystectomy (LC) has dramatically changed the outlook of patients with symptomatic gallstone disease. Empyema of the gallbladder is a potentially fatal complication of gallstones. It is characterized by suppuration superimposed on acute cholecystitis.

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The clinical presentation of this disease is often difficult to distinguish from acute cholecystitis.[1] Features suggesting diagnosis and seriousness of this disease are few. It used to be a contraindication for LC because of fear of life-threatening complications. It is also considered one of the commonest reasons for the conversion. Increasing experience and technology in the field of laparoscopic surgery has brought a significant change and a number of studies have reported LC to be safe and effective option in acute cholecystitis and associated conditions like empyema of the gallbladder. There can be various reasons and factors which can however, lead to conversion. Obscured local anatomy, uncontrolled bleeding and damage to nearby vital structures are the common factors responsible for conversion. Despite various encouraging reports, the role of laparoscopic surgery in such acute conditions is still under evaluation. This study aimed to find out safety and outcome of LC in empyema gallbladder.

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Laparoscopic cholecystectomy can be performed in empyema of gallbladder keeping in mind a slightly increased risk of complications even in the best hands. However, the experience of the surgeon plays a key role in the overall outcome.

Empyema of gall bladder is a severe form of acute cholecystitis with superadded suppuration. It has been considered a contraindication for the laparoscopic cholecystectomy (LC) because of fear of life-threatening complications. This study aimed to determine the safety and feasibility of LC in empyema of gallbladder.

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Source: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2980721/

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