title: Risk factors and therapeutic outcomes of acute acalculous cholecystitis.
abstract: OBJECTIVE
  Acute acalculous cholecystitis (AAC) is traditionally known to occur in critically ill patients and to have a poor prognosis. Although cholecystectomy is usually recommended for treating AAC, nonsurgical management may be a good alternative. The objective of this study was to review the incidence, risk factors, treatment modality, and therapeutic outcomes of AAC compared to acute calculous cholecystitis (ACC).
  
  
  METHODS
  Data from 69 patients with AAC and 415 patients with ACC between January 2007 and August 2011 were collected. Analysis and comparison of clinicopathological features and therapeutic outcomes between patients with AAC and those with ACC was performed.
  
  
  RESULTS
  The number of patients over 50 years of age was significantly higher in the AAC group compared with the ACC group (92.8 vs. 81.7%, p = 0.023). Cerebrovascular accidents were significantly more frequent in patients with AAC than in those with ACC (15.9 vs. 6.7%, p = 0.016). A higher incidence of gangrenous cholecystitis was observed in the AAC group (31.2 vs. 5.6%, p = 0.001). The overall therapeutic outcomes for patients did not differ statistically between the AAC and ACC groups, irrespective of treatment modalities. The recurrence rate after nonsurgical treatment was significantly lower in the AAC group than in the ACC group (2.7 vs. 23.2%, p = 0.005).
  
  
  CONCLUSIONS
  The risk of AAC increases in patients with advanced age and cerebrovascular accidents. Incidence of gangrenous cholecystitis was higher in AAC compared to ACC. Nonsurgical treatments such as antibiotics alone or percutaneous cholecystostomy might be effective in selected patients.
authors.affiliation: Yeungnam University College of Medicine, Daegu, Korea.
authors.forename: Min Geun
authors.initials: MG
authors.lastname: Gu
authors.forename: Tae Nyeun
authors.initials: TN
authors.lastname: Kim
authors.forename: Jay
authors.initials: J
authors.lastname: Song
authors.forename: Yoon Jeong
authors.initials: YJ
authors.lastname: Nam
authors.forename: Jae Young
authors.initials: JY
authors.lastname: Lee
authors.forename: Jun Suk
authors.initials: JS
authors.lastname: Park
mesh_terms: D042101:Acalculous Cholecystitis / Q000150:complications / Q000601:surgery / Q000628:therapy*; D000208:Acute Disease; D000368:Aged; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D002763:Cholecystectomy; D041881:Cholecystitis, Acute / Q000150:complications / Q000601:surgery / Q000628:therapy*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D012307:Risk Factors; D016896:Treatment Outcome; D014652:Vascular Diseases / Q000150:complications
chemical_list: D000900:Anti-Bacterial Agents