Empyema Gallbladder Surgery Dhaka

Empyema is the late stage of acute cholecystitis. The cystic duct is blocked by a stone, the trapped bile becomes infected, and the gallbladder distends with frank pus. Without urgent intervention, the wall can perforate — leading to bile peritonitis, abscess, and septic shock.

• Severe constant right-upper pain (worse than biliary colic)
• High fever (often >38.5 °C) with rigors
• Tachycardia, low blood pressure (sepsis signs)
• Tender, palpable mass in right upper abdomen
• Raised white-cell count and CRP; ultrasound shows distended gallbladder with debris and thickened wall

Treatment is urgent laparoscopic cholecystectomy within 24–72 hours of presentation, after IV antibiotics, fluid resuscitation, and (for unstable patients) percutaneous cholecystostomy drainage. Dr. Arefin uses a low-threshold for sub-total cholecystectomy when Calot's triangle anatomy is obscured by inflammation — this is safer than insisting on standard dissection in a fragile, septic patient.

Hospital stay is typically 3–5 days for drainage of inflammation, IV antibiotics, and monitoring. A drain is sometimes left in the gallbladder fossa for 48 hours. Most patients return to normal activities within 3–4 weeks. Open conversion rates are higher (10–20%) than for elective surgery — patient safety always takes priority over the laparoscopic approach. Contact the chamber urgently if symptoms suggest empyema.