Managing Gall Bladder Perforation in the Setting of Percutaneous Nephrolithotomy – Challenges скачать в хорошем качестве

Managing Gall Bladder Perforation in the Setting of Percutaneous Nephrolithotomy – Challenges

Managing Gall Bladder Perforation in the Setting of Percutaneous Nephrolithotomy – Challenges and Clinical Insights Layman Abstract : Percutaneous nephrolithotomy (PCNL) is the preferred surgery for removing large and complex kidney stones. However, in rare cases, it can cause injury to nearby organs, such as the gallbladder, especially on the right side. If the gallbladder is damaged and leads to infection (peritonitis), it can result in serious complications. This report describes a case where a patient underwent PCNL without any apparent issues, but the surgeon noticed an unusual fluid during the procedure, raising suspicion of gallbladder injury. A follow-up laparoscopic examination confirmed a bile leak and gallbladder damage. To prevent further complications, the gallbladder was surgically removed. The patient experienced a brief episode of temporary bowel slowdown (paralytic ileus) but otherwise had a smooth recovery and was discharged on the third day after surgery. This case highlights the importance of early detection and quick treatment of gallbladder injuries during PCNL to prevent life-threatening infections. ---------- Original Abstract : The preferred treatment for patients with big and complex renal calculi is percutaneous nephrolithotomy (PCNL). Rarely, this surgery can result in visceral damage. Injuries from needle punctures are more likely to occur in a gall bladder (GB) which borders the kidney on the right side. A worse outcome is predicted by GB damage that results in peritonitis. A GB perforation case was described that followed an otherwise unremarkable PCNL and received prompt intraoperative laparoscopic cholecystectomy treatment. The treating surgeon was alerted when the first puncture produced a straw-coloured, gelatinous aspirate. After PCNL, a diagnostic laparoscopy was performed. A bile leak and damage to the gall bladder were discovered. Cholecystectomy was performed electively. The postoperative period was uneventful other than a brief period of paralytic ileus. The patient recovered well and was discharged from the hospital on the third postoperative day. Since early identification can avoid mortality associated with peritonitis and sepsis due to GB perforation during PCNL, it is imperative to be aware of this potentially fatal consequence and to have a high index of suspicion for prompt timely treatment. View Book: https://doi.org/10.9734/bpi/mono/978-... #Percutaneous_nephrolithotomy #complications #gall_bladder_injury #laparoscopic_cholecystectomy