Singh Harpyar, Chejara Raj Kumar, Thippeswamy Nirupendra G, Sangtam Lirangla, Kapoor Eshan, Zahid Mohhammad, Suohu Kuozokhotuo, Dinkar Rajat, Jindal Khushal
Department of General Surgery, Vardhman Mahavir Medical College and Safdarjung Hospital, New Delhi, IND.
Cureus. 2025 May 25;17(5):e84791. doi: 10.7759/cureus.84791. eCollection 2025 May.
Gallbladder perforation (GBP) is a serious, life-threatening condition that can result from acute cholecystitis, trauma, or gallstone disease. Diagnosis remains challenging due to its nonspecific symptoms, often mimicking other abdominal pathologies. This study aimed to investigate the clinical features, diagnostic approaches, management strategies, and outcomes of GBP at a tertiary care center.
A retrospective cohort study was conducted at Vardhman Mahavir Medical College (VMMC) and Safdarjung Hospital from January 2022 to February 2025. Patients aged 18 years and older diagnosed with GBP were included, with those with trauma or malignancy excluded. Demographic, clinical, diagnostic, and treatment data were collected and analyzed.
A total of 72 patients were included, predominantly aged >40 years (73.9%), with a higher prevalence in females (67.1%). Diabetes (26.1%) and hypertension (17.8%) were the most common comorbidities. The most frequent symptom was right upper quadrant pain (93%), with a mean presentation time of 18.6 days. Imaging (USG and CT) revealed that 67/72 cases were diagnosed with GBP, with the fundus being the most common site of perforation. Most patients (69.8%) received conservative management with antibiotics, while 16.6% underwent percutaneous drainage procedures. The overall mortality rate was 2.7%.
GBP presents with diverse clinical manifestations, and early diagnosis is crucial to reduce complications. Non-resolution of symptoms with significant pericholecystic collection warrants percutaneous drainage, a minimally invasive procedure with low morbidity. A multidisciplinary approach is essential for optimal management, particularly in complex cases requiring interval cholecystectomy.
胆囊穿孔（GBP）是一种严重的、危及生命的疾病，可由急性胆囊炎、创伤或胆结石疾病引起。由于其症状不具特异性，常与其他腹部疾病相似，因此诊断仍具有挑战性。本研究旨在调查一家三级医疗中心GBP的临床特征、诊断方法、管理策略及治疗结果。
于2022年1月至2025年2月在瓦尔丹·马哈拉吉医学院（VMMC）和萨夫达容医院进行了一项回顾性队列研究。纳入年龄在18岁及以上诊断为GBP的患者，排除有创伤或恶性肿瘤的患者。收集并分析人口统计学、临床、诊断和治疗数据。
共纳入72例患者，主要年龄>40岁（73.9%），女性患病率较高（67.1%）。糖尿病（26.1%）和高血压（17.8%）是最常见的合并症。最常见的症状是右上腹疼痛（93%），平均发病时间为18.6天。影像学检查（超声和CT）显示，72例中有67例被诊断为GBP，穿孔最常见的部位是胆囊底部。大多数患者（69.8%）接受了抗生素保守治疗，而16.6%接受了经皮引流术。总死亡率为2.7%。
GBP临床表现多样，早期诊断对于减少并发症至关重要。胆囊周围有大量积液且症状未缓解时，需要进行经皮引流，这是一种发病率低的微创手术。多学科方法对于优化管理至关重要，特别是在需要分期胆囊切除术的复杂病例中。
