Copyright
©The Author(s) 2023. Published by Baishideng Publishing Group Inc. All rights reserved.
Gallbladder perforation with fistulous communication
Alejandro Quiroga-Garza, Neri Alejandro Alvarez-Villalobos, Milton Alberto Muñoz-Leija, Mariano Garcia-Campa, Hermilo Jeptef Angeles-Mar, Guillermo Jacobo-Baca, Rodrigo Enrique Elizondo-Omana, Santos Guzman-Lopez
Alejandro Quiroga-Garza, Milton Alberto Muñoz-Leija, Hermilo Jeptef Angeles-Mar, Guillermo Jacobo-Baca, Rodrigo Enrique Elizondo-Omana, Santos Guzman-Lopez, Human Anatomy Department, Universidad Autonoma de Nuevo Leon, School of Medicine, Monterrey 64460, Nuevo Leon, Mexico
Alejandro Quiroga-Garza, General Surgery Division, Hospital de Traumatología y Ortopedia No. 21, Instituto Mexicano del Seguro Social, Monterrey 64000, Nuevo Leon, Mexico
Neri Alejandro Alvarez-Villalobos, Mariano Garcia-Campa, Plataforma INVEST Medicina UANL-KER Unit Mayo Clinic, Universidad Autonoma de Nuevo Leon, School of Medicine, Monterrey 64460, Nuevo Leon, Mexico
Neri Alejandro Alvarez-Villalobos, Family Medicine Division, Instituto Mexicano del Seguro Social, Monterrey 64000, Nuevo Leon, Mexico
Milton Alberto Muñoz-Leija, Surgery Division, Hospital General de Zona No. 6, Instituto Mexicano del Seguro Social, Monterrey 64000, Nuevo Leon, Mexico
Author contributions: Quiroga-Garza A and Alvarez-Villalobos NA contributed equally to this work and should be considered as co-first authors; Quiroga-Garza A, Alvarez-Villalobos NA, Angeles-Mar HJ, Garcia-Campac M, Muñoz-Leija MA, Jacobo-Baca G, Elizondo-Omaña RE, and Guzmán-López S contributed to study conception and design, and drafting and critical revision of the manuscrip; Quiroga-Garza A, Alvarez-Villalobos NA, Angeles-Mar HJ, Garcia-Campac M, and Muñoz-Leija MA contributed to acquisition of the data; Quiroga-Garza A, Alvarez-Villalobos NA, Angeles-Mar HJ, Garcia-Campac M, Muñoz-Leija MA, and Guzmán-López S contributed to analysis and interpretation of the data.
Conflict-of-interest statement: The authors declare no conflict of interest for this article.
PRISMA 2009 Checklist statement: The authors have read the PRISMA 2009 Checklist, and the manuscript was prepared and revised according to the PRISMA 2009 Checklist.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See:
https://creativecommons.org/Licenses/by-nc/4.0/ Corresponding author: Rodrigo Enrique Elizondo-Omana, MD, PhD, Professor, Research Fellow, Research Scientist, Human Anatomy Department, Faculty of Medicine and University Hospital “Dr. José Eleuterio González”, Universidad Autónoma de Nuevo León (U.A.N.L.), Avenida Francisco I. Madero y Gonzalitos s/n Colonia Mitras Centro, Monterrey 64460, Nuevo Leon, Mexico. rod_omana@yahoo.com
Received: January 20, 2023
Peer-review started: January 20, 2023
First decision: February 14, 2023
Revised: February 17, 2023
Accepted: April 19, 2023
Article in press: April 19, 2023
Published online: June 27, 2023
BACKGROUND
The management of gallbladder perforation (GBP) with fistulous communication (Neimeier type I) is controversial.
AIM
To recommend management options for GBP with fistulous communication.
METHODS
A systematic review of studies describing the management of Neimeier type I GBP was performed according to the PRISMA guidelines. The search strategy was conducted in Scopus, Web of Science, MEDLINE, and EMBASE (May 2022). Data extraction was obtained for patient characteristics, type of intervention, days of hospitalization (DoH), complications, and site of fistulous communication.
RESULTS
A total of 54 patients (61% female) from case reports, series, and cohorts were included. The most frequent fistulous communication occurred in the abdominal wall. Patients from case reports/series had a similar proportion of complications between open cholecystectomy (OC) and laparoscopic cholecystectomy (LC) (28.6 vs 12.5; P = 0.569). Mortality was higher in OC (14.3 vs 0.0; P = 0.467) but this proportion was given by only one patient. DoH were higher in OC (mean 26.3 d vs 6.6 d). There was no clear association between higher rates of complications of a given intervention in cohorts, and no mortality was observed.
CONCLUSION
Surgeons must evaluate the advantages and disadvantages of the therapeutic options. OC and LC are adequate options for the surgical management of GBP, with no significant differences.
Core Tip: Gallbladder perforations are rare. Management guidelines are non-specific. Although a clear benefit of laparoscopic cholecystectomy over open cholecystectomy is lacking, with the increase in laparoscopic training and availability, this approach may demonstrate superiority in time.
