Factores de riesgo asociados a colecistitis aguda gangrenosa

Autores/as

  • Carlos Alberto Córdova-Velázquez Instituto Mexicano del Seguro Social, Centro Médico Nacional La Raza, Hospital de Especialidades “Dr. Antonio Fraga Mouret”. Departamento de Cirugía General. Ciudad de México, México. https://orcid.org/0000-0002-2286-0015
  • Jesús Arenas-Osuna Instituto Mexicano del Seguro Social, Centro Médico Nacional La Raza, Hospital de Especialidades “Dr. Antonio Fraga Mouret”. Departamento de Cirugía General. Ciudad de México, México.
  • Saraí Betsabé Jiménez Robles Instituto Mexicano del Seguro Social, Centro Médico Nacional La Raza, Hospital de Especialidades “Dr. Antonio Fraga Mouret”. Departamento de Cirugía General. Ciudad de México, México.
  • Omar González Méndez Instituto Mexicano del Seguro Social, Centro Médico Nacional La Raza, Hospital de Especialidades “Dr. Antonio Fraga Mouret”. Departamento de Cirugía General. Ciudad de México, México.
  • Enrique Jesús Rodríguez Espino Instituto Mexicano del Seguro Social, Centro Médico Nacional La Raza, Hospital de Especialidades “Dr. Antonio Fraga Mouret”. Departamento de Cirugía General. Ciudad de México, México.

DOI:

https://doi.org/10.52787/agl.v54i2.402

Palabras clave:

Colecistitis aguda, colecistectomía, colecistitis gangrenosa

Resumen

Introducción. La colecistitis aguda gangrenosa es una complicación severa de la colecistitis aguda, de difícil diagnóstico prequirúrgico.

Objetivo. Evaluar factores de riesgo asociados a colecistitis aguda gangrenosa.

Material y métodos. Estudio caso-control, retrospectivo, observacional y analítico de pacientes con colecistitis aguda gangrenosa, diagnosticados entre enero de 2017 y enero de 2022. Los pacientes se dividieron en dos grupos según el diagnóstico anatomopatológico: colecistitis aguda gangrenosa (casos) y colecistitis aguda no gangrenosa (controles).

Resultados. Se incluyeron un total de 159 pacientes, 40 casos y 119 controles. La edad media en los casos fue 51,2 años y en los controles 48 años. En el análisis multivariado se observó que el nivel de plaquetas menor a 275.000/mm3 (OR 8,21 IC95% 1,62-41,62, p = 0,01), la presencia de fiebre (OR 19,68, IC95% 3,93-98,42, p = 0,000) y el antecedente patológico de diabetes (OR 6,94, IC95% 1,21-39,85, p = 0,03) se asociaron de manera independiente con colecistitis aguda gangrenosa.

Conclusiones. En nuestra población, el nivel de plaquetas menor a 275.000/ mm3, la presencia de fiebre y el antecedente patológico de diabetes fueron factores de riesgo para colecistitis aguda gangrenosa.

Citas

-1. Gomes CA, Soares C, Di Saverio S, Sartelli M, et al. Gangrenous cholecystitis in male patients: A study of prevalence and predictive risk factors. Ann Hepatobiliary Pancreat Surg.2019 Feb;23(1):34-40. DOI: 10.14701/ahbps.2019.23.1.34

-2. Yokoe M, Hata J, Takada T, et al. Tokyo Guidelines 2018: diagnostic criteria and severity grading of acute cholecystitis (with videos). J Hepatobiliary Pancreat Sci. 2018 Jan; 25(1):41-54. DOI: 10.1002/jhbp.515

-3. Okamoto K, Suzuki K, Takada T, et al. Tokyo Guidelines 2018: flowchart for the management of acute cholecystitis. J Hepatobiliary Pancreat Sci.2018 Jan;25(1):55-72. DOI: 10.1002/jhbp.516

-4. Kimura Y, Takada T, Kawarada Y, et al. Definitions, pathophysiology, and epidemiology of acute cholangitis and cholecystitis: Tokyo Guidelines. J Hepatobiliary Pancreat Surg. 2007;14(1):15-26. DOI: 10.1007/s00534-006-1152-y

-5. Lee SK, Lee SC, Park JW, et al. The utility of the preoperative neutrophil-to-lymphocyte ratio in predicting severe cholecystitis: a retrospective cohort study. BMC Surg. 2014 Nov 27; 14:1-7. DOI: 10.1186/1471-2482-14-100

-6. Beliaev AM, Angelo N, Booth M, et al. Evaluation of neutrophil-to-lymphocyte ratio as a potential biomarker for acute cholecystitis. J Surg Res.2017 Mar; 209:93-101. DOI: 10.1016/j.jss.2016.09.034

-7. Wevers KP, van Westreenen HL, Patijn GA. Laparoscopic cholecystectomy in acute cholecystitis: C-reactive protein level combined with age predicts conversion. Surg Laparosc Endosc Percutan Tech. 2013 Apr;23(2):163-6. DOI: 10.1097/SLE.0b013e31826d7fb0

-8. Yuzbasioglu Y, Duymaz H, Tanrikulu CS, et al. Role of Procalcitonin in Evaluation of the Severity of Acute Cholecystitis. Eurasian J Med.-2016 Oct; 48(3):162-166. DOI: 10.5152/eurasianmedj.2016.0052

-9. Fagan SP, Awad SS, Rahwan K, et al. Prognostic factors for the development of gangrenous cholecystitis. Am J Surg. 2003 Nov;186(5):481-5. DOI: 10.1016/j.amjsurg.2003.08.001

-10. Cheng WC, Chiu YC, Chuang CH, et al. Assessing clinical outcomes of patients with acute calculous cholecystitis in addition to the Tokyo grading: a retrospective study. Kaohsiung J Med Sci. 2014 Sep; 30(9):459-65. DOI: 10.1016/j.kjms.2014.05.005

-11. Asai K, Watanabe M, Kusachi S, et al. Evaluating the timing of laparoscopic cholecystectomy for acute cholecystitis in an experienced center based on propensity score matching. Asian J Endosc Surg.2017 May;10(2):166-172. DOI: 10.1111/ases.12353

-12. Endo I, Takada T, Hwang TL, et al. Optimal treatment strategy for acute cholecystitis based on predictive factors: Japan-Taiwan multicenter cohort study. J Hepatobiliary Pancreat Sci. 2018 May; 25(5):346-61. DOI: 10.1002/jhbp.456

-13. Mayhew D, Mendonca V, Murthy BVS. A review of ASA physical status - historical perspectives and modern developments. Anaesthesia. 2019 Mar;74(3):373-9. DOI: 10.1111/anae.14569

-14. Merriam LT, Kanaan SA, Dawes LG, et al. Gangrenous cholecystitis: analysis of risk factors and experience with laparoscopic cholecystectomy. Surgery.-1999 Oct; 126(4):680-5. DOI: 10.1016/S0039-6060(99)70122-4

-15. Kohga A, Okumura T, Yamashita K, Isogaki J, Kawabe A, Kimura T. Does early surgery imply a critical risk for patients with Grade III acute cholecystitis? Asian J Endosc Surg. 2021 Jan;14(1):7-13. DOI: 10.1111/ases.12799

-16. Aydin C, Altaca G, Berber I, et al. Prognostic parameters for the prediction of acute gangrenous cholecystitis. J Hepatobiliary Pancreat Surg. 2006;13(2):155-9. DOI: 10.1007/s00534-005-1042-8

-17. Taveras, L., Scrushy, M., Cripps, M., Kuhlenschmidt, K., Crandall, M., Puri, R., Schroeppel, T., Schuster, K., & Dumas, R. (2023). From mild to gangrenous cholecystitis, laparoscopic cholecystectomy is safe 24 hours a day. The American Journal of Surgery, 226(1), 83-86. https://doi.org/10.1016/j.amjsurg.2023.01.029

-18. Nikfarjam M, Niumsawatt V, Sethu A, et al. Outcomes of contemporary management of gangrenous and non-gangrenous acute cholecystitis. HPB (Oxford).2011 Aug;13(8):551-8. DOI: 10.1111/j.1477-2574.2011.00327.x

-19. Nguyen L, Fagan SP, Lee TC, et al. Use of a predictive equation for diagnosis of acute gangrenous cholecystitis. Am J Surg.2004 Nov;188(5):463-6. DOI: 10.1016/j.amjsurg.2004.07.013

-20. Hunt DR, Chu FC. Gangrenous cholecystitis in the laparoscopic era. Aust N Z J Surg. 2000 Jun;70(6):428-30. DOI: 10.1046/j.1440-1622.2000.01851.x

-21. Asti, E., Lovece, A., & Bonavina, L. (2020). Gangrenous cholecystitis during hospitalization for SARS-CoV2 infection. Updates in Surgery, 72, 917-919. https://doi.org/10.1007/s13304-020-00814-6

-22. Bouassida, M., Madhioub, M., Kallel, Y., Zribi, S., Slama, H., Mighri, M., & Touinsi, H. (2021). Acute gangrenous cholecystitis: Proposal of a score and comparison with previous published scores. Journal of Gastrointestinal Surgery, 25, 1479-1486. https://doi.org/10.1007/s11605-020-04707-2

-23. Chen, J., Gao, Q., Huang, X., & Wang, Y. (2022). Prognostic clinical indexes for prediction of acute gangrenous cholecystitis and acute purulent cholecystitis. BMC gastroenterology, 22(1), 1-8. https://doi.org/10.1186/s12876-022-02582-6

-24. Shirah, B., Shirah, H., Saleem, M., Chughtai, M., Elraghi, M., & Shams, M. (2019). Predictive factors for gangrene complication in acute calculous cholecystitis. Ann Hepatobiliary Pancreat Surg, 23(3), 228-233. https://doi.org/10.14701/ahbps.2019.23.3.228

-25. Daly, T., Byrne, J., & Aftab, F. (2023). Gallbladder torsion with gangrenous cholecystitis: A case report. Journal of Surgical Case Reports, 2023(5), 1. https://doi.org/10.1093/jscr/rjad252

-26. Fang, R., Yerkovich, S., & Chandrasegaram, M. (2022). Pre-operative predictive factors for gangrenous cholecystitis at an Australian quaternary cardiothoracic center. ANZ Journal of Surgery, 92(4), 781-786.

-27. Gomes, C., Soares, C., Di Saverio, S., Sartelli, M., de Souza, P., Orlandi, A., Lacerda, T., Couto, F., & Catena, F. (2019). Gangrenous cholecystitis in male patients: A study of prevalence and predictive risk factors. Ann Hepatobiliary Pancreat Surg, 23(1), 34-40. https://synapse.koreamed.org/articles/1117187

Descargas

Publicado

01-07-2024

Cómo citar

Córdova-Velázquez, C. A., Arenas-Osuna, J., Jiménez Robles, S. B., González Méndez, O., & Rodríguez Espino, E. J. (2024). Factores de riesgo asociados a colecistitis aguda gangrenosa. Acta Gastroenterológica Latinoamericana, 54(2), 147–152. https://doi.org/10.52787/agl.v54i2.402