Perforácia žlčníka // SOLEN

Slovenská chirurgia 4/2019

Gallbladder perforation

Gallbladder perforation is a serious complication of acute cholecystitis. It occurs in about 2 - 11% of cholecystitis cases. The approach to treatment and management has changed considerably since its classification by Niemeier in 1934. Niemeier divided gallbladder perforations into three types: type I - acute perforation into free peritoneal cavity, type II - subacute perforation with abscess formation and type III - chronic perforation with fistula formation between galbladder and other organ with or without development of biliary ileus. Galbladder perforation presents a challenge in diagnosis, treatment and is associated with high morbidity and mortality. However, since the classification into three types mentioned above, the possibilities of diagnostics as well as therapeutic options have evolved considerably, leading to increased treatment success rate and a consequent decline in mortality.

Keywords: cholecystitis, gallbladder perforation, biliary ileus, Niemeier classification