Two Cases of Gallbladder Torsion in Elderly Patients Treated by Laparoscopic Cholecystectomy

Abstract

Case 1 was a 91-year-old woman who was admitted to the hospital complaining of progressively worsening abdominal pain. The laboratory data showed evidence of slight inflammation. Abdominal CT showed a very swollen and edematous gallbladder, which was non-enhancing. A diagnosis of cholecystitis was made and laparoscopic cholecystectomy was performed. Intraoperatively, a floating gallbladder was recognized, with the gallbladder twisted 360 degrees anticlockwise along its longitudinal axis. Case 2 was a 93-year-old woman who was admitted to the hospital complaining of upper abdominal and back pain. The laboratory data revealed evidence of slight inflammation. Abdominal CT showed a swollen and edematous gallbladder, which was non-enhancing. The patient was diagnosed as having gallbladder torsion, and laparoscopic cholecystectomy was performed. The gallbladder was found to be twisted 540 degrees clockwise along its longitudinal axis. Surgery in the elderly is associated with a high frequency of preoperative comorbidities and a high risk of postoperative complications, and can be fatal. Early diagnosis and early laparoscopic cholecystectomy are important for successful treatment of gallbladder torsion.