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. 2023 Jun 27;15(6):1191-1201.
doi: 10.4240/wjgs.v15.i6.1191.

Gallbladder perforation with fistulous communication

Alejandro Quiroga-Garza  1   2 , Neri Alejandro Alvarez-Villalobos  3   4 , Milton Alberto Muñoz-Leija  1   5 , Mariano Garcia-Campa  3 , Hermilo Jeptef Angeles-Mar  1 , Guillermo Jacobo-Baca  1 , Rodrigo Enrique Elizondo-Omana  6 , Santos Guzman-Lopez  1
Affiliations

Gallbladder perforation with fistulous communication

Alejandro Quiroga-Garza et al. World J Gastrointest Surg. .

Abstract

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.

Keywords: Fistulous communication; Gallbladder perforation; Laparoscopic cholecystectomy; Open cholecystectomy.

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Conflict of interest statement

Conflict-of-interest statement: The authors declare no conflict of interest for this article.

Figures

Figure 1
Figure 1
CONSORT diagram. GBP 1: Gallbladder perforation Neiemier type 1; LC: Laparoscopic cholecystectomy; OC: Open cholecystectomy.
Figure 2
Figure 2
Post-intervention complications after cholecystectomy. LC: Laparoscopic cholecystectomy; OC: Open cholecystectomy; CI: Confidence interval.
See this image and copyright information in PMC

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