Inoue H, Ochiai T, Kubo H, Yamamoto Y, Morimura R, Ikoma H, Otsuji E. Laparoscopic cholecystectomy for gangrenous cholecystitis in around nineties: Two case reports. World J Clin Cases 2021; 9(14): 3424-3431 [PMID: 34002154 DOI: 10.12998/wjcc.v9.i14.3424]
Corresponding Author of This Article
Toshiya Ochiai, MD, PhD, Assistant Professor, Department of Surgery, North Medical Center Kyoto Prefectural University of Medicine, Kyoto 6292261, Japan. tochiai@koto.kpu-m.ac.jp
Research Domain of This Article
Surgery
Article-Type of This Article
Case Report
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (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: http://creativecommons.org/licenses/by-nc/4.0/
Hiroyuki Inoue, Division of Digestive Surgery, Department of Surgery, Kyoto Prefectual University of Medicine, Kyoto 6028566, Japan
Toshiya Ochiai, Department of Surgery, North Medical Center Kyoto Prefectural University of Medicine, Kyoto 6292261, Japan
Hidemasa Kubo, Yusuke Yamamoto, Ryo Morimura, Hisashi Ikoma, Eigo Otsuji, Division of Digestive Surgery, Department of Surgery, Kyoto Prefectural University of Medicine, Kyoto 6028566, Japan
Author contributions: Inoue H wrote the manuscript and got the figures; Inoue H and Ochiai T contributed to the discussion and interpretation of this manuscript; Otsuji E made the critical revision; all authors have read and approved the manuscript.
Informed consent statement: All study participants, or their legal guardian, provided informed written consent prior to study enrollment.
Conflict-of-interest statement: The authors declare that they have no conflict-of-interests.
CARE Checklist (2016) statement: The authors have read the CARE Checklist (2016), and the manuscript was prepared and revised according to the CARE Checklist (2016).
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: http://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Toshiya Ochiai, MD, PhD, Assistant Professor, Department of Surgery, North Medical Center Kyoto Prefectural University of Medicine, Kyoto 6292261, Japan. tochiai@koto.kpu-m.ac.jp
Received: December 31, 2020 Peer-review started: December 31, 2020 First decision: January 27, 2021 Revised: February 5, 2021 Accepted: March 17, 2021 Article in press: March 17, 2021 Published online: May 16, 2021 Processing time: 118 Days and 17 Hours
Abstract
BACKGROUND
Gangrenous cholecystitis is a form of acute cholecystitis which involves gangrenous alterations in the gallbladder wall and it often follows an acute and serious course. We herein report on two cases of very elderly people diagnosed early with gangrenous cholecystitis, who safely underwent laparoscopic cholecystectomy (LC) and both demonstrated a good outcome.
CASE SUMMARY
Case 1: An 89-year-old female. She underwent abdominal contrast-enhanced computed tomography (CECT) due to abdominal pain and diarrhea. Her gallbladder wall indicated the absence of contrast enhancement, thus leading to diagnosis of gangrenous cholecystitis and she therefore underwent LC. Although her gallbladder demonstrated diffuse necrosis and it was also partly perforated, she was able to be discharged without any serious complications. Case 2: A 91-year-old female. She made an emergency visit with a chief complaint of abdominal pain. Abdominal CECT revealed swelling of the gallbladder and an ambiguous continuity of the gallbladder wall. She was diagnosed with gangrenous cholecystitis and underwent LC. Her gallbladder had swelling and diffuse necrosis. Although her preoperative blood culture was positive, she showed a good outcome following surgery.
CONCLUSION
Although a definite diagnosis of gangrenous cholecystitis is difficult to make prior to surgery, if an early diagnosis can be made and appropriate treatment can be carried out, then even very elderly individuals may be discharged without major complications.
Core Tip: Gangrenous cholecystitis is a form of acute cholecystitis which involves gangrenous alteration in the gallbladder wall and often follows acute and serious course. We report on two cases of very elderly people diagnosed with gangrenous cholecystitis, who safely underwent laparoscopic cholecystectomy and made good progress. If early diagnosis of gangrenous cholecystitis and an appropriate treatment method can be carried out, even very elderly individuals may be discharged without major complications. Our paper will be very informative and useful to the readers of World Journal of Clinical Cases in today's aging society, and will be frequently cited.
