Management of Empyema Gallbladder During COVID-19 Pandemic

Abstract

Cholecystostomy is performed in high-risk patients with gall bladder disease. These patients are generally elderly with multiple comorbidities; in particular cardiac patients with uncontrolled diabetes, and present late with acute cholecystitis with systemic inflammation. The management of such high-risk patients requires multi-departmental approach. COVID-19 pandemic has widely affected the management guidelines including timing of surgery, extent of pre-operative optimization, use of laparoscopy for surgery and intensive care requirement. We report a case of elderly hypertensive and diabetic patient who presented during the first wave of COVID-19 pandemic with fever, vomiting and pain abdomen. He was diagnosed with empyema gallbladder. Cholecystostomy was performed as a temporizing measure which was followed by elective laparoscopic cholecystectomy as daycare admission. This averted the need for possible intensive care stay and emergency surgery whereas providing equally good outcome.