• Injury · Jan 2022

    Trauma to the gallbladder is associated with concurrent injuries to the wider hepatobiliary system: A South African experience.

    • Victor Kong, William Xu, Cynthia Cheung, Nigel Rajaretnam, Abdalla Elsabagh, Jhanvi Dholakia, John Bruce, Grant Laing, Vassil Manchev, and Damian Clarke.
    • Department of Surgery, University the Witwatersrand, Johannesburg, South Africa; Department of Surgery, Waikato Hospital, Hamilton, New Zealand; Department of Surgery, University of KwaZulu Natal, Durban, South Africa. Electronic address: victorywkong@yahoo.com.
    • Injury. 2022 Jan 1; 53 (1): 98-102.

    IntroductionGallbladder trauma is a rare injury. This study aimed to describe the significance of these injuries and the appropriate management strategies.MethodsA retrospective study was undertaken at a major trauma centre in South Africa and included all patients diagnosed with a gallbladder injury between January 2012 and October 2020.ResultsA total of 51 cases were included (88% male, mean age: 38 years), with 44 (86%) penetrating trauma cases [28 stab wounds (SW), 16 sustained gunshot wounds (GSW)]. Of the 7 (13%) blunt trauma cases, five were involved in a motor vehicle crash, and two were injured via assault. All patients underwent laparotomy. Full-thickness gallbladder laceration or perforation was the most common type of injury (84%) and all patients with a gallbladder perforation or laceration had a cholecystectomy at index operation. Two out of 5 patients with a gallbladder contusion were managed conservatively without a cholecystectomy and the remaining three had evidence of gallbladder necrosis which were managed with cholecystectomy. Associated extrahepatic bile duct injuries occurred in 4% of cases, and 18 cases (35%) required intensive care unit (ICU) admission. The overall mortality was 8%.ConclusionGallbladder injury is rare but when encountered implies a significant degree of trauma. Although cholecystectomy is usually definitive, there is an association with other occult extra-hepatic biliary tract injuries. The severity of the associated injuries usually determines patient outcomes.Copyright © 2021 Elsevier Ltd. All rights reserved.

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