Gallbladder mucocele part 2: treatment and prognosis

Abstract

As discussed in part 1 of this series, gallbladder mucocele is defined as a build-up of immobile mucus within the gallbladder that can result in extrahepatic biliary obstruction, pressure necrosis of the gallbladder wall and, ultimately, rupture. Although many gallbladder mucoceles are discovered during abdominal ultrasonography while screening for other diseases, patients with mature gallbladder mucoceles or gallbladder rupture can present as an emergency. Medical management with hepatoprotectants, choleretics, antibiotics and suitable diet can be attempted in certain cases, but cholecystectomy remains the gold standard treatment option. If an underlying cause is detected (such as an endocrinopathy), this should be treated accordingly. Mortality rates following gallbladder removal vary from 16–40%. A high mortality rate has been associated with septic bile peritonitis, hyperadrenocorticism and/or pancreatitis as a concurrent disease.