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J Minim Access Surg. 2019 Jan 4. doi: 10.4103/jmas.JMAS_267_18. [Epub ahead of print]

Laparoscopic management of intra-hepatic gallbladder perforation.

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Department of Surgery, Grant Medical College and Sir JJ Group of Hospitals, Mumbai, Maharashtra, India.
Deenanath Mangeshkar Hospital and Research Centre, Pune, Maharashtra, India.


Intra-hepatic perforation of the gallbladder (GB) leading to hepatic abscess is a serious and rare complication of cholecystitis, with very few sporadically reported cases in the literature. Hence, there is no standard approach to treat it. A thorough radiological evaluation with computed tomography and endoscopic retrograde cholangiopancreatography is necessary before proceeding with surgery in such cases. An early laparoscopic intervention to perform a sub-total cholecystectomy with drain placement is enough to treat both cholecystitis and liver abscess in a definitive manner. While previous reports have advocated an open surgery, our series demonstrates that early laparoscopic management is a safe and suitable approach in such cases.


Cholecystitis; cholecystohepatic fistula; endoscopic retrograde cholangiopancreatography; gallbladder perforation; laparoscopic cholecystectomy

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