Risk Factors Associated with Acute Gangrenous Cholecystitis
DOI:
https://doi.org/10.52787/agl.v54i2.402Keywords:
Acute cholecystitis, cholecystectomy, gangrenous cholecystitisAbstract
Introduction. Acute gangrenous cholecystitis is a serious complication of acute cholecystitis, which is difficult to diagnose preoperatively.
Aim. To assess risk factors associated with acute gangrenous cholecystitis.
Material and methods. Case-control, retrospective, observational, and analytical study of patients with acute cholecystitis, diagnosed between January 2017 and January 2022. Patients were divided into two groups according to anatomopathologic diagnosis: acute gangrenous cholecystitis (cases) and acute non-gangrenous cholecystitis (controls).
Results. A total of 159 patients were included, 40 cases and 119 controls. The mean age was 51.2 years in cases and 48 years in controls. Multivariate analysis showed that platelet counts less than 275,000/mm3 (OR 8.21, 95% CI 1.62-41.62, p = 0.01), presence of fever (OR 19.68, 95% CI 3.93-98.42, p = 0.000) and the pathologic history of diabetes (OR 6.94, 95% CI 1.21-39.85, p = 0.03) were independently associated with acute gangrenous cholecystitis.
Conclusions. In our population, the platelet level is less than 275,000/mm3, and the presence of fever and a pathological history of diabetes were risk factors for acute gangrenous cholecystitis.
References
-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
Published
How to Cite
Issue
Section
License
Copyright (c) 2024 Carlos Alberto Córdova-Velázquez, Jesús Arenas-Osuna, Saraí Betsabé Jiménez Robles, Omar González M´éndez, Jesús Enrique Rodríguez Espino
This work is licensed under a Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License.
