Abstract

LAPAROSCOPIC CHOLECYSTECTOMY FOR EMPYEMA GALL BLADDER – A CASE REPORT

Dr. Neha M. Upadhyay* and Dr. Nandkishor V. Borse

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Abstract

Empyema of the gallbladder is a complication of cholecystitis that can develop into sepsis if not treated promptly. Signs and symptoms of gallstone disease are nausea/vomiting, right upper quadrant tenderness, and a history of gallstone disease. With persistence of the obstruction, inflammation and bacterial overgrowth within the gallbladder lumen and tissue, it may lead to eventual venous congestion, pressure necrosis and even empyema of the gallbladder. Clinicians should keep the abnormal presentations of gallbladder empyema in mind and prepare themselves for a presentation different from imaging during surgery. Several prognostic factors including gallbladder wall thickness, gender, white cell count, and diabetes mellitus have been associated with severe complicated cholecystitis and empyema of the gallbladder. Surgical intervention such as laparoscopic cholecystectomy has been shown to be necessary and a safe modality to manage patients with significant gallbladder pathology but should be performed as early as possible in the disease process. Intraoperative drainage of the gallbladder and possible subtotal cholecystectomy should be considered.

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