Our Summary

This research paper is about a surgery performed on a man in his early 60s who was suffering from severe abdominal pain. The man had a condition where a stone was stuck in the neck of his gallbladder, which caused the gallbladder to become infected and even start to die, while also causing a localized infection in the lining of his abdominal cavity.

To treat this, the doctors first drained his gallbladder using a minimally invasive procedure. A week later, they performed a laparoscopic surgery, which is a type of surgery where small incisions are made and a camera is used to guide the surgery. To aid in the surgery, they used a special technique where a fluorescent dye was injected into the patient. This dye made it easy to see the gallbladder and bile ducts, which are small tubes that carry a fluid called bile.

The use of this fluorescent dye made it easier for the doctors to safely remove the patient’s diseased gallbladder. After the surgery, the patient recovered well and reported no pain or discomfort at a check-up two months later.

FAQs

  1. What is the approach used to treat gangrenous cholecystitis with perforation (GCP)?
  2. What technique was used in the laparoscopic cholecystectomy to visualize the cystic and common bile ducts during surgery?
  3. What were the results of the surgery and how did the patient recover post-surgery?

Doctor’s Tip

A helpful tip a doctor might tell a patient about laparoscopic cholecystectomy is to follow post-operative care instructions carefully, including avoiding heavy lifting and strenuous activities for a period of time to allow for proper healing. It’s important to also watch for signs of infection, such as fever or increased pain, and to contact your doctor if you experience any unusual symptoms during your recovery.

Suitable For

Patients who are typically recommended for laparoscopic cholecystectomy include those with symptomatic gallstones, acute cholecystitis, chronic cholecystitis, gallbladder polyps, or gallbladder dyskinesia. In cases of gangrenous cholecystitis with perforation, like the patient described in the case report, surgery may be necessary to remove the diseased gallbladder and prevent further complications. The use of fluorescence imaging guidance during laparoscopic cholecystectomy can help surgeons visualize the bile ducts and safely remove the gallbladder, leading to successful outcomes and minimal postoperative complications.

Timeline

  • Before laparoscopic cholecystectomy: A patient experiences right upper abdominal pain for 3 days, leading to a visit to the hospital. Imaging tests such as computed tomography and ultrasonography reveal findings consistent with gangrenous cholecystitis with perforation and localized peritonitis. Percutaneous gallbladder drainage may be performed as an initial treatment.

  • After laparoscopic cholecystectomy: The patient undergoes laparoscopic cholecystectomy 7 days later, using fluorescence imaging guidance for visualization of the cystic and common bile ducts during surgery. The diseased gallbladder is safely removed, and the patient recovers well without complications. At a 2-month follow-up, the patient reports no pain or discomfort.

What to Ask Your Doctor

  1. What is laparoscopic cholecystectomy and why is it recommended for my condition?
  2. What are the risks and benefits of undergoing laparoscopic cholecystectomy for gangrenous cholecystitis with perforation?
  3. How long will the procedure take and what is the recovery process like?
  4. Will I need any additional tests or procedures before the surgery?
  5. What kind of anesthesia will be used during the surgery?
  6. How soon after the surgery can I resume normal activities and work?
  7. Are there any dietary restrictions or lifestyle changes I should follow after the surgery?
  8. What are the potential complications of laparoscopic cholecystectomy for my specific condition?
  9. How long will I need to stay in the hospital after the surgery?
  10. Are there any alternative treatments or surgical options available for my condition?

Reference

Authors: Xie Q, Yang M, Jiang K, Zhang L, Mao T, Gao F. Journal: J Int Med Res. 2023 Dec;51(12):3000605231216396. doi: 10.1177/03000605231216396. PMID: 38064274