title: Gallbladder perforation: clinical presentation, predisposing factors, and surgical outcomes of 46 patients.
abstract: OBJECTIVE
  We aimed to investigate the clinical features and the relation between patient characteristics and the different types of gallbladder perforation and to determine the predisposing factors.
  
  
  METHODS
  The medical records of 478 patients who received urgent surgical treatment with the diagnosis of acute cholecystitis and underwent urgent surgery in our clinics between January 1997 and November 2008 were reviewed retrospectively. The demographic data of patients, time elapsed from the onset of the symptoms to the time of surgery, comorbidity status, American Society of Anesthesiologists classification, laboratory data, imaging results, surgical procedures, postoperative complications, and postoperative length of stay of the patients were analyzed.
  
  
  RESULTS
  There were 46 (9.6%) patients with the diagnosis of gallbladder perforation. Morbidity and mortality occurred in 15 (32.6%) and 7 (15.2%) patients, respectively. Advanced age, male gender, fever >38°C, high white blood cell count, and presence of cardiovascular comorbidity were found to be significant risk factors for gallbladder perforation.
  
  
  CONCLUSIONS
  While early diagnosis and early surgical intervention are the keys to managing gallbladder perforation, we suggest that patients having the above-mentioned clinical features should be carefully investigated.
authors.affiliation: Balıkesir University, School of Medicine, Department of General Surgery, Balıkesir, Turkey. hayrullahderici@yahoo.com
authors.forename: Hayrullah
authors.initials: H
authors.lastname: Derıcı
authors.forename: Erdinç
authors.initials: E
authors.lastname: Kamer
authors.forename: Cemal
authors.initials: C
authors.lastname: Kara
authors.forename: Haluk Recai
authors.initials: HR
authors.lastname: Ünalp
authors.forename: Tuğrul
authors.initials: T
authors.lastname: Tansuğ
authors.forename: Ali Doğan
authors.initials: AD
authors.lastname: Bozdağ
authors.forename: Okay
authors.initials: O
authors.lastname: Nazli
mesh_terms: D000367:Age Factors; D000368:Aged; D017081:Cholecystectomy, Laparoscopic; D041881:Cholecystitis, Acute / Q000150:complications; D005260:Female; D005705:Gallbladder Diseases / Q000175:diagnosis* / Q000209:etiology* / Q000601:surgery; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D012307:Risk Factors; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome