Gallbladder perforation with fistulous communication

Table 1 Surgical treatment from case report/series studies and cohorts

Year	Patients with type I GBP	Men	Women	Lap Chol			Open Chol			Conservative treatment
				n	Qx pre	Qx post	n	Qx pre	Qx post
≤ 2005	2	1	1	1	1	0	0	0	0	1
2006-2010	3	1	2	0	0	0	2	0	0	1
2011-2015	3	0	3	1	0	0	1	0	0	1
2016-2020	25	11	14	19	0	0	5	0	1	1
≥ 2021	22	5	17	5	4	0	17	4	0	0

GBP: Gallbladder perforation; Lap Chol: Laparoscopic cholecystectomy; Open Chol: Open cholecystectomy; Qx: Surgery or procedure; pre: Previous to the cholecystectomy; post: After the cholecystectomy.

Table 2 Patient characteristics of case reports/series

Fistulous communication	N (fem)	Site of perforation			Preoperative diagnosis	Laparoscopic cholecystectomy (converted)	Open cholecystectomy	Conservative	Added procedures
		Fundus	Body	Neck
Abdominal wall	11 (8)	3	3	3	9	3 (1)	7	1	1 ERCP
Gastric	4 (4)	-	-	1	2	2	1	1
Duodenum	3 (1)	-	-	-	3	2 (2)	2	1	1 ERCP
Colon	2 (1)	2	-	-	2	0	2	0	1 ERCP
Pleura	1 (0)	-	-	-	1	1	0	0	1 pleural tube
Total	20 (13)1	5	3	31	161	8 (3)	12	3	4

¹One patient had both abdominal wall and gastric fistula.

N: Sample size; fem: Female; converted: Laparoscopic cholecystectomy converted to open; ERCP: Endoscopic retrograde cholangiopancreatography.

Table 3 Surgical outcomes in case report/series patients

Surgical approach	n	Cx	P value	Convertion	P value	Mortality	P value	DoH	P value
Open Chol	7	2	0.550	NA	0.213	1	0.438	26.3 (± 22.71)	0.277
Lap Chol	9	1		3		0		7.0 (± 5.11)

¹Four patients were not included in this analysis due to their conservative management.

It is reported as the mean ± SD. P value was calculated using Chi-square test, with statistical significance set at < 0.05. DoH: Days of hospitalization; Lap Chol: Laparoscopic cholecystectomy; Open Chol: Open cholecystectomy.

Table 4 Patient characteristics of cohort studies

Ref.	N (fem)	Mean age	Site of perforation			Preoperative diagnosis	Laparoscopic cholecystectomy (converted)	Open cholecystectomy	Conservative	Added procedures	DoH post chol
			Fundus	Body	Neck
Gupta et al[10], 2022	20 (16)	53.1	7	11	2	2	3 (0)	17	0	8	10.64 ± 6.39
Sahbaz et al[42], 2017	15 (5)	71.8	7	5	2	11	14 (0)	1	0	0	1.691

¹Not specific to gallbladder perforation (GBP) type 3 (data from 133 patients with GBP).

N: Sample size; fem: Female; converted: Laparoscopic cholecystectomy converted to open; added procedures included 5 common bile duct explorations and 3 choledochoduodenostomies; DoH post-chol: Days of hospitalization post-cholecystectomy.