Laparoscopic Management of Spontaneous Gallbladder Perforation in Acalculous Cholecystitis: A Case Series.

Gallbladder perforation in acalculous cholecystitis is rare and has a high mortality rate due to biliary peritonitis and sepsis. Here, we present a case series of successful laparoscopic management of Spontaneous gallbladder perforation in acalculous cholecystitis. In the first case, a 44-year-old male patient presented to the emergency room with a history of three days of fever with chills and acute pain in the abdomen for two days. This was a case of typhoid-induced acalculous cholecystitis with gallbladder perforation, which is a rare clinical entity. The second case was a 62-year-old male, a known diabetic presented with pain abdomen and fever for four days. This was a case of acalculous spontaneous gallbladder perforation. The third case was a 53-year-old female patient with gallbladder perforation in acalculous cholecystitis. Radiological investigations suggested gallbladder perforation which was confirmed on diagnostic laparoscopy in all the cases. Laparoscopic cholecystectomy with peritoneal lavage was performed. All the patients did well postoperatively and were discharged on postoperative day 4 after drain removal. One should be clinically vigilant about gallbladder perforation in a case of acalculous cholecystitis. Minimal access surgery techniques like laparoscopy can be applied to confirm the diagnosis as well as for definitive management.