A Case of Gallbladder Perforation Treated By Percutaneous Transhepatic Cholecystic Drainage and Percutaneous Peritoneal Drainage

Cho, Sung Won; Shim, Chan Sup; Lee, Joon Seong; Lee, Moon Sung; Park, Chan Wook; Song, Dong Wha; Kwon, Kang Ho; Hong, Soo Jin

Abstract

Perforation of gallbladder is a serious complication of acute cholecystitis with alarmingly high mortality rate. These high mortality and morbidity rates were caused by delay in prompt diagnosis and adequate therapy. Especially, mortality and morbidity rates rise markedly in the elderly patient with severe systemic illness. In the patients of gallbladder perforation who are poor candidate for general anesthesia and major operation, percutaneous cholecystic drainage procedure is good alternatives. We experienced a case of gallbladder perforation which was treated successfully by non-operative percutaneous transhepatic cholecystic drainage(PTCCD) in 65-year-old female. She couldn't be a candidate for cholecystectomy or operative chlecystostomy because of severe adhesion of gallbladder to adjacent organ and tissue due to previous gallbladder empyema. We decided to take non-operative percutaneous transhepatic cholecystic drainage and percutaneous peritoneal drainage of abdominal abscess. Thereafter, we examined gallbladder by percutaneous transhepatic cholecystoscopylPTCCS)and rule out gallstone and gallbladder malignancy. So, we presented the case with the brief review of the literatures.