Advertisement

Updates in Surgery

, Volume 70, Issue 4, pp 495–502 | Cite as

The value of intraoperative percutaneous aspiration of the mucocele of the gallbladder for safe laparoscopic management

  • Bader Hamza Shirah
  • Hamza Asaad Shirah
  • Khalid Bataa Albeladi
Original Article
  • 19 Downloads

Abstract

Mucocele of the gallbladder is an overdistended gallbladder filled with mucoid content. It is under-reported in humans, and literature review showed insufficient data about the incidence and the factors affecting the laparoscopic management. We aim to evaluate the intraoperative aspiration of the mucoid contents of the gallbladder as a factor influencing the outcome of the treatment. A prospective cohort database analysis of the results of patients who were diagnosed as mucocele of the gallbladder and treated laparoscopically between January 2003 and December 2012 was done. Diagnostic results, ultrasound findings, operative diagnosis, duration of symptoms, length of hospitalization, and complications were analyzed. 57 patients were diagnosed with mucocele of the gallbladder. The incidence rate was 5.85%. Male to female ratio was 1:1.48 and the mean age of patients was 37.41 ± 7.12 years. Ultrasound suspected mucocele in 24 (42%) patients. Laparoscopic cholecystectomy was performed in all 57 (100%) patients, and aspiration of mucoid fluid was done to all. Aspiration of the mucocele contents intraoperatively as a factor for safe laparoscopic management of mucocele of the gallbladder was found to represent a significant difference statistically (P  =  0.02). Morbidity and mortality rates were recorded as zero (0%). Laparoscopic cholecystectomy could efficiently manage mucocele of the gallbladder with morbidity and mortality rates as low as 0%. The most important factor influencing the success of the procedure is the intraoperative aspiration of the mucoid contents of the gallbladder. Collapsing of the gallbladder wall was a keystone in the non-complicated laparoscopic procedure.

Keywords

Gallbladder Mucocele Aspiration Overdistended gallbladder 

Notes

Acknowledgement

The authors would like to acknowledge the late Dr. Abdull monem Al hadi (died 2013), and the late Dr. Ahmad Deghaidi (died 2014) for their clinical participation in the surgical part of the study.

Compliance with ethical standards

Conflict of interest

The authors declare that they have no conflict of interest.

Research involving human participants and/or animals

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards. The study was formally approved by the ethics committee of the institution where it was developed.

Informed consent

Informed consent was obtained from all individual participants included in this study.

References

  1. 1.
    Agrawal S, Jonnalagadda S (2000) Gallstones, from gallbladder to gut. Management options for diverse complications. Postgrad Med. 108(3):149–153 (143–6) CrossRefGoogle Scholar
  2. 2.
    Feldman M (ed) (1998) Sleisenger and fordtran’s gastrointestinal and liver disease, 6th edn. WB Saunders Company, PhiladelphiaGoogle Scholar
  3. 3.
    Rosen P, Barkin R (1998) Emergency medicine: concepts and clinical practice, 4th edn. Mosby-Year Book Inc., St. LouisGoogle Scholar
  4. 4.
    Damjanov I, Linder J (1996) Diseases of the digestive system: gallbladder and extrahepatic ducts. Anderson’s Pathology, vol 2, 10th edn. Mo: Mosby-Year Book, St. LouisGoogle Scholar
  5. 5.
    Wight DGD, Symmers WS (eds) (1994) Systemic pathology. The Liver, Biliary Tract and Exocrine Pancreas, 3rd ed, vol 11, Churchill Livingstone, Philadelphia.Google Scholar
  6. 6.
    Georgiades CP, Mavromatis TN, Kourlaba GC et al (2008) Is inflammation a significant predictor of bile duct injury during laparoscopic cholecystectomy? Surg Endosc 22(9):1959–1964CrossRefGoogle Scholar
  7. 7.
    Popkharitov AI (2008) Laparoscopic cholecystectomy for acute cholecystitis. Langenbecks Arch Surg 393(6):935–941CrossRefGoogle Scholar
  8. 8.
    Gurusamy KS, Samraj K, Fusai G, Davidson BR (2009) Robot assistant for laparoscopic cholecystectomy. Cochrane Database Syst Rev. 1:CD006578Google Scholar
  9. 9.
    Mahid SS, Jafri NS, Brangers BC, Minor KS, Hornung CA, Galandiuk S (2009) Meta-analysis of cholecystectomy in symptomatic patients with positive hepatobiliary iminodiacetic acid scan results without gallstones. Arch Surg 144(2):180–187CrossRefGoogle Scholar
  10. 10.
    Widmer J, Singhal S, Gaidhane M, Kahaleh M (2014) Endoscopic ultrasound-guided endoluminal drainage of the gallbladder. Dig Endosc 26(4):525–531CrossRefGoogle Scholar
  11. 11.
    Cox MR, Wilson TG, Luck AJ, Jeans PL, Padbury RT, Toouli J (1993) Laparoscopic cholecystectomy for acute inflammation of the gallbladder. Ann Surg 218(5):630–634CrossRefGoogle Scholar
  12. 12.
    Fitzgerald JE, White MJ, Lobo DN (2009) Courvoisier’s gallbladder: law or sign? World J Surg 33(4):886–891CrossRefGoogle Scholar
  13. 13.
    Mofti AB, Al-momen A, Suleiman SI et al (1994) The single gallbladder stone—is it innocent? Ann Saudi Med 14(6):471–473CrossRefGoogle Scholar
  14. 14.
    Vijayaraghavan R, Belagavi CS (2006) Double gallbladder with different disease entities: A case report. J Minim Access Surg 2(1):23–26CrossRefGoogle Scholar
  15. 15.
    Maurer K, Unsinn KM, Waltner-romen M, Geiger R, Gassner I (2008) Segmental bowel-wall thickening on abdominal ultrasonography: an additional diagnostic sign in Kawasaki disease. Pediatr Radiol 38(9):1013–1016CrossRefGoogle Scholar
  16. 16.
    Sebastian S, Araujo C, Neitlich JD, Berland LL (2013) Managing incidental findings on abdominal and pelvic CT and MRI, part 4: white paper of the ACR Incidental Findings Committee II on gallbladder and biliary findings. J Am Coll Radiol 10(12):953–956CrossRefGoogle Scholar
  17. 17.
    Calik A, Topaloglu S, Topcu S, Turkyilmaz S, Kucuktulu U, Piskin B (2007) Routine intraoperative aspiration of gallbladder during laparoscopic cholecystectomy. Surg Endosc 21(9):1578–1581CrossRefGoogle Scholar

Copyright information

© Italian Society of Surgery (SIC) 2018

Authors and Affiliations

  1. 1.King Abdullah International Medical Research CenterKing Saud bin Abdulaziz University for Health SciencesJeddahSaudi Arabia
  2. 2.Department of General SurgeryAl Ansar General HospitalMedinaSaudi Arabia
  3. 3.King Abdulaziz Medical City/King Saud bin Abdulaziz University for Health SciencesJeddahSaudi Arabia

Personalised recommendations