Gallbladder perforation with cholecystopleural fistula: a case report

Abstract

The cholelithiasis is a common pathology, however, if left untreated may cause a gallbladder perforation (GBP). This complication can include local or generalized biliary spillage, or a fistulous communication to an adjacent organ. We report a case of a patient with cholecystopleural fistula in a 71-year-old male. Complicated cholelithiasis presented fistulous GBP into the right pleura cavity, progressing into an empyema. The diagnosis was made preoperatively with computed tomography, and the patient was treated with a laparoscopic cholecystectomy, thoracostomy tube, and a biliopleural fistulectomy. The postsurgical outcome was satisfactory, with uneventful follow-up 3 weeks after.

Gallbladder perforation with fistulous communication

“…Nine patients denied comorbidities. The most common comorbidity was diabetes mellitus followed by cardiovascular diseases ( )[ 26 - 41 ]. Preoperative diagnosis was identified as a cholecystic fistula in 16 patients (4 not reported).…”

“…Except for two case reports and one case series which had an overall low risk of bias, the rest presented a moderate risk of bias. This was most commonly due to the patient(s) selection, as it did not represent the whole experience of the investigator’s center ( )[ 26 - 41 ].…”

“…A laparoscopic approach with fistulous communication resection was decided to avoid negative pressure drainage with a chest tube[ 17 ]. A thoracic vs abdominal approach for the resection is still controversial[ 26 ].…”