Evaluation of Patients with Gall Bladder Perforation: Experience at a Tertiary Centre

Abstract

Introduction: Gall bladder perforation is a rare but serious complication that presents to our emergency setup. It is usually a sequelae of acute cholecystitis.It requires urgent intervention, failing which mortality can be as high as more than 50%. Neimeier classification of GB perforation has since become the guide to its management. Because of infrequent and rare occurrence of GB perforation the data regarding incidence and management of it is lacking. We present our experience at a tertiary centre of 35 cases of gall bladder perforation that presented to us since January 2020 till June 2022

Material and methods: This is a retrospective study conducted in Department of Surgery, JNMC, AMU. It includes all the cases of gb perforation that presented, diagnosed and were managed at our hospital from January 2020 till June 2022. Following data were evaluated:age, gender, diagnostic procedure, duration of hospital stay, management, type of procedure,Histopathology, outcome.

Observation: 35 patients were evaluated in our study. Type 1 comprised of 11 patients, maximum patients were from type 2 i.e. 22 out of 35 and type 3 gb perforation comprised of 2 patients according to Neimeier classification. For patients who presented with type 1 perforation, emergency laparotomy with open cholecystectomy and peritoneal lavage was done.Patients with type 2 Gall Bladder perforation were managed conservatively. Type 3 GB perforation has a complicated course ranging from its diagnosis to management. Overall, 3 patients out of 35 expired. 2 of them were type 1 and one was type 3.

Conclusion: Early diagnosis of Gall bladder perforation is the key for proper management of these patients. The algorithm provided by Neimeier is the guide to proceed.