Perforation of the gallbladder: a clinical study.

An analysis of 3,260 admissions to St. Francis General Hospital during a 20-year period for acute and chronic cholecystitis and two traumatic gallbladder perforations revealed 115 cases for an incidence of 3.5 percent. The most common gallbladder perforation in this series was localized perforation with abscess formation in 72 patients (63 percent). Other perforations were fistulization to another hollow viscus, or to the skin, 32 (27.5 percent), and free perforation, 11 (9.5 percent) into the peritoneal cavity.Nineteen or 46 percent of 41 postoperative complications were related to bacterial infections. In spite of a complication rate of 32 percent, the mortality was zero.Of 115 cases categorized as perforated gallbladder, 63 percent were localized with abscess formation, and 9.5 and 27.5 percent, respectively, were classified as free and as fistulization. Mortality was zero; however, morbidity was 32 percent. The significant complications were related to infection, ie, wound, urologic, subphrenic, and pulmonary and leg vein. Early operation is indicated for acute cholecystitis after rapid preoperative perforation.