ArticleSurgical endoscopy2017
Outcome of acute perforated cholecystitis: a register study of over 5000 cases from a quality control database in Germany.
Article in Surgical endoscopy, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 15 papers.
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Who cites it
15 citing papers in PubMed, 29 citations in OpenAlex.
- Article
- Gallbladder Perforation: A 23-Year Study of 100 Patients and Evolving Management Strategies.Cureus · 2026Article
- From the operating room: Surgeons' views on difficult laparoscopic cholecystectomies.Annals of hepato-biliary-pancreatic surgery · 2025Article
- Article
- Indocyanine green fluorescence-guided surgery in the emergency setting: the WSES international consensus position paper.World journal of emergency surgery : WJES · 2025Article
- Delayed laparoscopic cholecystectomy for a patient with coronavirus disease 2019 who developed gangrenous cholecystitis: a case report.Surgical case reports · 2022Article
- Applications of indocyanine green in surgery: A single center case series.Annals of medicine and surgery (2012) · 2022Article
- Postoperative Outcomes after Index vs Interval Cholecystectomy for Perforated Cholecystitis.Journal of the American College of Surgeons · 2021Article
- Uncommon but valuable for diagnosis: Green deposits on peritoneal fluid cytospins.Clinical case reports · 2021Article
- Prognostic Significance of Ultrasound Findings of Acute Acalculous Cholecystitis for Elderly Long-Term Bedridden Patients.Frontiers in medicine · 2021Article
- Novel Use of Intraoperative Fluoroscopy in an Era of ICG for Complex Laparoscopic Cholecystectomy.Surgery journal (New York, N.Y.) · 2021Article
- The role of indocyanine green fluoroscopy for intraoperative bile duct visualization during laparoscopic cholecystectomy: an observational cohort study in 70 patients.Patient safety in surgery · 2019Article
- Spontaneous acalculous gallbladder perforation in a man secondary to chemotherapy and radiation: A rare case report.Medicine · 2018Article
- Advanced gallbladder inflammation is a risk factor for gallbladder perforation in patients with acute cholecystitis.World journal of emergency surgery : WJES · 2018Article
- Anatomical mapping of the biliary tree during laparoscopic cholecystectomy by using indocyanine green dye.Journal of minimal access surgeryArticle
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Authors and funding
5 authors at 2 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundAcute perforated cholecystitis (APC) is probably the most severe complication of acute cholecystitis. However, data on the outcome of cholecystectomy for APC are limited to small series. This study investigated the outcomes of cholecystectomy for APC.
methodsData from a prospectively maintained quality control database in Germany were analyzed. Cases with APC were compared to cases without gallbladder perforation with regard to demographic characteristics, clinical findings and surgical outcomes.
resultsA total of 5704 patients with APC were compared to 39,661 patients without perforation. Risk factors for APC included: the male gender, advanced age (>65 years), ASA score >2, elevated white blood count (WBC), positive findings on abdominal ultrasound sonography and fever. The APC group differed significantly from the control group with regard to fever (29.8 vs. 12.2 %), elevated WBC (83.8 vs. 65.4 %) and positive findings from ultrasound sonography (84.9 vs. 78.9 %), p < 0001. Preoperative computed tomography (CT) was ordered significantly more often in the APC group compared to the control group (2.3 vs. 1.0 %, p = 0.001). Surgery lasted significantly longer in the APC group (92.3 ± 40.8 vs. 73.7 ± 34.1, p < 0.001). The rates of conversion (18.9 vs. 6.8 %), bile duct injury (1.4 vs. 0.5 %), re-intervention (6.9 vs. 2.9 %) and mortality (4.3 vs. 1.3 %) were significantly higher in the APC group (p < 0.001). Similarly, the length of stay (13.4 ± 11.4 vs. 9.0 ± 8.3, p < 0.001) was significantly longer in the APC group.
conclusionAcute perforated cholecystitis is a severe complication of acute cholecystitis. Surgical dissection could be challenging with high risks of bile duct injury and conversion. The rates of morbidity and mortality are higher compared to those of patients without perforation.
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