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The Safety of Laparoscopic Surgery in Treatment of Empyema Gall Bladder

Authors: Ibrahim Ekhlayef Mughir Al- Doghan --- Hasanain abdulameer jasim --- Haitham Khalid Hussein
Journal: Mustansiriya Medical Journal مجلة المستنصرية الطبية ISSN: 20701128 22274081 Year: 2017 Volume: 16 Issue: 3 Pages: 91-94
Publisher: Al-Mustansyriah University الجامعة المستنصرية


Background: Empyema Gallbladder is a sequel of severe acutecholecystitis. Previously, laparoscopic cholecystectomy was relativelycontraindicated because of fatal complications. Objectives: Todetermine the safety of laparoscopic surgery in treatment of empyema gallbladder. Methods: A retrospective study conducted on 92 patientsfrom Nov. 2007 to May 2017, with gallbladder empyema who underwentlaparoscopic cholecystectomy at Al-Yarmouk teaching hospital inBaghdad, Iraq. The operation was done by using four ports. Results: A retrospective study of 92 case of empyema gallbladder, laparoscopic cholecystectomy was performed for 92 cases proved to have empyema gallbladder. A successful laparoscopic cholecystectomy done to 75 cases(81.52%) (Group I), a conversion to open cholecystectomy was done to 17(18.47%) (Group II) patients due to various reasons, the most common asa gangrenous wall of gallbladder 6 (6.5%) patients, bleeding from cystic artery 5 (5.4%) patients, severe obscured anatomy of Calot’s triangle duo to adhesions 3 (3.2%) patients. Duodenal injury 2 (2.1%) patients and common bile duct injury 1 (1.08%) patient. Maximum operative time was 80 minutes for all cases. Postoperative complications occurred in 22(29.3%) patients of Group I, and 9(52.9%) patients of Group II. Group I (75 patients) in whom successively laparoscopic cholecystectomy (LC) was done, and Group II (17 patients) where conversion to open cholecystectomy. About 53(70.6%) of Group I patients discharged from hospital within 1-3days, and about 9 (52.9%) of Group II patients discharged from hospital within 7days. Conclusions: Gallbladder Empyema is a serious sequel of acute cholecystitis, where the laparoscopic cholecystectomy can be done to treat it safely.

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