Objective: Our aim was to present a single-center experience in the management of gallbladder perforation
(GBP).
Patients and methods: Adult patients who had GBP were managed surgically and percutaneously. Patients
who were high risk surgical candidates or who refused surgery were managed by image guided percutaneous
drainage.
Results: Thirty-seven patients (21 males, 16 females) with an average age of 64 ± 14 years had GBP. The
number of patients with GBP type I, II, and III were 13, 21, and 3, respectively. All GBP types I and III
patients were treated surgically. Eleven of GBP type II patients were treated surgically, and 10 were treated
by percutaneous catheter drainage. The overall mortality rate was 27% (10/37). No procedure-related
mortality rate among those patients who were treated percutaneously; however, 30 days post procedure,
the mortality rate was 30%. All of these deaths were related to the patients’ comorbidities; none of them
was due to septicemia but conversely in surgically treated patients, 5 died due to septicemia (3 in GBP
type I and 2 in GBP type II) in the postoperative period and one patient died because of severe internal
hemorrhage complicating acute pancreatitis and one patient died few months later because of myocardial
infarction.
Conclusion: Surgery is the cornerstone of treatment for all types of GBP. Percutaneous catheter drainage
is a safe and effective option for treating patients with localized disease with favorable outcome.