Prognostic parameters for the prediction of acute gangrenous cholecystitis.
OBJECTIVE
The aim of this study was to identify preoperative prognostic parameters for gangrenous cholecystitis to differentiate this subgroup of patients with acute cholecystitis in order to provide immediate surgical therapy.


METHODS
The medical records of patients who had an emergency cholecystectomy with the diagnosis of acute cholecystitis between January 2002 and June 2005 were reviewed retrospectively. Univariate and multivariate analysis were performed on the data.


RESULTS
Out of 203 individuals with the clinical diagnosis of acute cholecystitis, 21 (10.3%) patients had a histological diagnosis of gangrenous cholecystitis. Multivariate analysis demonstrated an independent association of male sex, diabetes mellitus and white blood cell (WBC) count with the development of acute gangrenous cholecystitis.


CONCLUSIONS
The risk for gangrenous cholecystitis is increased in male patients who have diabetes and a greater WBC count than 14 900/mm(3). Urgent surgical intervention should be considered for these patients because of the high morbidity and mortality rate of the condition.
First General Surgery Department, Haydarpasa Numune Research and Training Hospital, Istanbul, Turkey.
Cagatay
C
Aydin
Gülüm
G
Altaca
Ibrahim
I
Berber
Koray
K
Tekin
Melih
M
Kara
Izzet
I
Titiz
D016009:Chi-Square Distribution; D002763:Cholecystectomy; D041881:Cholecystitis, Acute / Q000473:pathology* / Q000601:surgery; D005260:Female; D005734:Gangrene / Q000473:pathology* / Q000601:surgery; D006801:Humans; D008111:Liver Function Tests; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D011379:Prognosis; D012372:ROC Curve; D012189:Retrospective Studies; D012307:Risk Factors