# Laparoscopic Cholecystectomy for Necrotic Perforated Cholecystitis in a Super-obese, Highly Frail Patient: A Case Report

## TL;DR

A super-obese, highly frail elderly woman with severe gallbladder disease was successfully treated with laparoscopic surgery, showing it can be safe in high-risk patients.

## Contribution

Demonstrates successful laparoscopic cholecystectomy in a super-obese, highly frail patient with necrotic perforated cholecystitis.

## Key findings

- Laparoscopic cholecystectomy was safely performed in a 72-year-old super-obese patient with multiple comorbidities.
- The patient had no postoperative complications and was discharged successfully.
- This case suggests laparoscopic surgery can be viable for high-risk patients with necrotic perforated cholecystitis.

## Abstract

Acute necrotic perforated cholecystitis is a life-threatening condition requiring urgent surgical treatment. The risk of morbidity and mortality increases in patients with high frailty. Here, we present a rare case of necrotic perforated cholecystitis treated with laparoscopic cholecystectomy in a 72-year-old female patient with a BMI of 54.6 kg/m2, diabetes, a recent cerebrovascular event, and cardiac and pulmonary diseases. She presented with abdominal pain after being hospitalized for an acute ischemic stroke two weeks prior. CT scan revealed gangrenous cholecystitis and gallbladder perforation. The patient underwent a laparoscopic cholecystectomy. No complications were observed in the postoperative period. The patient was discharged without complications. Laparoscopic cholecystectomy can be safely applied in selected patients with necrotic perforated cholecystitis who are super obese and have very high frailty due to comorbidities.