Delayed laparoscopic cholecystectomy for a patient with coronavirus disease 2019 who developed gangrenous cholecystitis: a case report

Abstract Background Gangrenous cholecystitis has a high risk of perforation and sepsis; therefore, cholecystectomy in the early stage of the disease is recommended. However, during the novel coronavirus disease 2019 (COVID-19) pandemic, the management of emergent surgeries changed to avoid contagion...

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Main Authors: Yurie Yoshida, Tomohiro Iguchi, Norifumi Iseda, Kosuke Hirose, Takuya Honboh, Noriko Iwasaki, Seiya Kato, Noriaki Sadanaga, Hiroshi Matsuura
Format: Article
Language:English
Published: Japan Surgical Society 2022-07-01
Series:Surgical Case Reports
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Online Access:https://doi.org/10.1186/s40792-022-01494-7
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author Yurie Yoshida
Tomohiro Iguchi
Norifumi Iseda
Kosuke Hirose
Takuya Honboh
Noriko Iwasaki
Seiya Kato
Noriaki Sadanaga
Hiroshi Matsuura
author_facet Yurie Yoshida
Tomohiro Iguchi
Norifumi Iseda
Kosuke Hirose
Takuya Honboh
Noriko Iwasaki
Seiya Kato
Noriaki Sadanaga
Hiroshi Matsuura
author_sort Yurie Yoshida
collection DOAJ
description Abstract Background Gangrenous cholecystitis has a high risk of perforation and sepsis; therefore, cholecystectomy in the early stage of the disease is recommended. However, during the novel coronavirus disease 2019 (COVID-19) pandemic, the management of emergent surgeries changed to avoid contagion exposure among medical workers and poor postoperative outcomes. Case presentation A 56-year-old man presented to our hospital with abdominal pain. Computed tomography revealed intraluminal membranes, an irregular or absent wall, and an abscess of the gallbladder, indicating acute gangrenous cholecystitis. Early laparoscopic cholecystectomy seemed to be indicated; however, a COVID-19 antigen test was positive despite no obvious pneumonia on chest computed tomography and no symptoms. After discussion among the multidisciplinary team, antibiotic therapy was started and percutaneous transhepatic gallbladder drainage (PTGBD) was planned for the following day because the patient’s vital signs were stable and his abdominal pain was localized. Fortunately, the antibiotic therapy was very effective, and PTGBD was not needed. The cholecystitis improved and the patient was discharged from the hospital on day 10. One month later, laparoscopic delayed cholecystectomy was performed after confirming a negative COVID-19 polymerase chain reaction test result. The postoperative course was uneventful, and the patient was discharged on postoperative day 2 in satisfactory condition. Conclusion We have reported a case of acute gangrenous cholecystitis in a patient with asymptomatic COVID-19 disease. This report can help to determine treatment strategies for patients with gangrenous cholecystitis during future pandemics.
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spelling doaj-art-d8cedb9259c64662b4bd6c642161a7172025-08-20T02:51:14ZengJapan Surgical SocietySurgical Case Reports2198-77932022-07-01811510.1186/s40792-022-01494-7Delayed laparoscopic cholecystectomy for a patient with coronavirus disease 2019 who developed gangrenous cholecystitis: a case reportYurie Yoshida0Tomohiro Iguchi1Norifumi Iseda2Kosuke Hirose3Takuya Honboh4Noriko Iwasaki5Seiya Kato6Noriaki Sadanaga7Hiroshi Matsuura8Department of Surgery, Saiseikai Fukuoka General HospitalDepartment of Surgery, Saiseikai Fukuoka General HospitalDepartment of Surgery, Saiseikai Fukuoka General HospitalDepartment of Surgery, Saiseikai Fukuoka General HospitalDepartment of Surgery, Saiseikai Fukuoka General HospitalDepartment of Internal Medicine, Saiseikai Fukuoka General HospitalDivision of Pathology, Saiseikai Fukuoka General HospitalDepartment of Surgery, Saiseikai Fukuoka General HospitalDepartment of Surgery, Saiseikai Fukuoka General HospitalAbstract Background Gangrenous cholecystitis has a high risk of perforation and sepsis; therefore, cholecystectomy in the early stage of the disease is recommended. However, during the novel coronavirus disease 2019 (COVID-19) pandemic, the management of emergent surgeries changed to avoid contagion exposure among medical workers and poor postoperative outcomes. Case presentation A 56-year-old man presented to our hospital with abdominal pain. Computed tomography revealed intraluminal membranes, an irregular or absent wall, and an abscess of the gallbladder, indicating acute gangrenous cholecystitis. Early laparoscopic cholecystectomy seemed to be indicated; however, a COVID-19 antigen test was positive despite no obvious pneumonia on chest computed tomography and no symptoms. After discussion among the multidisciplinary team, antibiotic therapy was started and percutaneous transhepatic gallbladder drainage (PTGBD) was planned for the following day because the patient’s vital signs were stable and his abdominal pain was localized. Fortunately, the antibiotic therapy was very effective, and PTGBD was not needed. The cholecystitis improved and the patient was discharged from the hospital on day 10. One month later, laparoscopic delayed cholecystectomy was performed after confirming a negative COVID-19 polymerase chain reaction test result. The postoperative course was uneventful, and the patient was discharged on postoperative day 2 in satisfactory condition. Conclusion We have reported a case of acute gangrenous cholecystitis in a patient with asymptomatic COVID-19 disease. This report can help to determine treatment strategies for patients with gangrenous cholecystitis during future pandemics.https://doi.org/10.1186/s40792-022-01494-7COVID-19Gangrenous cholecystitisLaparoscopic cholecystectomy
spellingShingle Yurie Yoshida
Tomohiro Iguchi
Norifumi Iseda
Kosuke Hirose
Takuya Honboh
Noriko Iwasaki
Seiya Kato
Noriaki Sadanaga
Hiroshi Matsuura
Delayed laparoscopic cholecystectomy for a patient with coronavirus disease 2019 who developed gangrenous cholecystitis: a case report
Surgical Case Reports
COVID-19
Gangrenous cholecystitis
Laparoscopic cholecystectomy
title Delayed laparoscopic cholecystectomy for a patient with coronavirus disease 2019 who developed gangrenous cholecystitis: a case report
title_full Delayed laparoscopic cholecystectomy for a patient with coronavirus disease 2019 who developed gangrenous cholecystitis: a case report
title_fullStr Delayed laparoscopic cholecystectomy for a patient with coronavirus disease 2019 who developed gangrenous cholecystitis: a case report
title_full_unstemmed Delayed laparoscopic cholecystectomy for a patient with coronavirus disease 2019 who developed gangrenous cholecystitis: a case report
title_short Delayed laparoscopic cholecystectomy for a patient with coronavirus disease 2019 who developed gangrenous cholecystitis: a case report
title_sort delayed laparoscopic cholecystectomy for a patient with coronavirus disease 2019 who developed gangrenous cholecystitis a case report
topic COVID-19
Gangrenous cholecystitis
Laparoscopic cholecystectomy
url https://doi.org/10.1186/s40792-022-01494-7
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