Dear Rasheed, I read with interest your article. There is an extremely low number of cases with exclusive gallbladder trauma where this conservative approach may be useful (Gallbladder injuries due to blunt abdominal trauma: Report on five cases and review of the literature. Rev. Paul. Med. 110(6):285-288,1992;Gallbladder injury in abdominal trauma: analysis of 32 cases.Rev Hosp Clin Fac Med Sao Paulo. 1993 Nov-Dec;48(6):283-8). Even in these rare events, the risk of stones due to use of non absorbable suture in a late follow up should be weight with the low risk and consequences of cholecystectomy. I believe that a cholecystectomy should be the treatment of choice in any event of gallbladder trauma. Even during an elective surgery, if I inadvertently injure the gallbladder, I proceed with its removal. Try to conserve it may pose an additional and unacceptable risk for the patient.

Esteemed Marcel, Thanks! For your contribution so far.

Dear Rasheed,

This is for sure an interesting question. I would advocate like Marcel for a low risk cholecystectomy in those circumstances. I would remove the gallbladder for any minor injury. However, it happened only once in my practice and I think we should, of course, try to avoid it. Best regards.

Dear Rasheed, a small hole in the gallbladder due to stab injury could be repaired in exceptional cases. In blunt trauma it is a deceleration injury and the wall of the gallbladder is mostly damaged and it doesn't make any sense to preserve it. The experimental work on dogs is a short term exam and we do not know whether the dogs ever develop stones in the gallbladder. And if any, it needs a longer time period. In conclusion, from my perspective there is no place for the preservation of gallbladder in traumatic lesions.