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February 1960

Perforation of the Gallbladder: An Evaluation of Its Significance

Author Affiliations

Ann Arbor, Mich.
From the Surgery Department, St. Joseph Mercy Hospital.

AMA Arch Surg. 1960;80(2):204-207. doi:10.1001/archsurg.1960.01290190024005

Perforation of the gallbladder has been well described in its three clinical forms. However, the importance of these three types of gallbladder perforation in the consideration of the treatment of acute cholecystitis needs clarification. Much has been made of the danger of gallbladder perforation. It has been held over the head of the clinician much like the sword over Damocles, ready to drop without warning or at the slightest false move in the care of those patients with acute cholecystitis. The fear of perforation or the hope of preventing perforation is often used as an argument for immediate surgery for acute cholecystitis. A high mortality following perforation has been reported many times, although such statistics need careful evaluation in their relation to the treatment of acute cholecystitis. It is the purpose of this paper to reevaluate the danger of gallbladder perforation in the treatment of acute cholecystitis.

Gallbladder perforation has

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