A Case of Acalculous Cholecystitis Which Developed One Month After Gastrectomy for Gastric Cancer

Abstract

A 77-year-old man complained of sudden right upper quadrant pain one month after distal gastrectomy with D2 lymphadenectomy. We diagnosed acute cholecystitis and performed cholecystectomy. Inflammation and necrosis was observed in the gallbladder wall. Acute acalculous cholecystitis is a high risk group of gallbladder perforation and gallbladder necrosis. Perforation and necrosis are associated with a high incidence of peritonitis. Although various causes of the acalculous cholecystitis have been reported, surgery is one of the possible etiologies. It is rare for acalculous cholecystitis to develop in the early postoperative period after distal gastrectomy. We performed cholecystomucoclasis (subtotal cholecystectomy and cauterization of the residual gallbladder mucosa), because of severe inflammation of Calot's triangle. The postoperative course was uneventful. In this case, cholecystomucoclasis was a safe and valid surgical procedure.