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

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.