title: Cholecystectomy for Acute Cholecystitis After Renal Transplantation.
abstract: BACKGROUND
  The aim of our study was to evaluate the rate of surgical complications, patient outcomes, and impact on graft function in renal transplant recipients in whom cholecystectomy for acute cholecystitis was performed.
  
  
  METHODS
  We reviewed data on transplant patients from January 1, 2006, to December 31, 2013. The subgroup of patients who required subsequent cholecystectomy for acute cholecystitis was assessed, and their data were further analyzed.
  
  
  RESULTS
  Thirty-one patients who underwent cholecystectomy for acute cholecystitis after renal transplantation were included in the study. Clinical signs such as pain in the right upper quadrant, temperature >38°C, and elevation in bilirubin levels occurred in 20 (64.5%), 8 (25.8%), and 3 (9.7%) patients, respectively. Ultrasound signs of acute cholecystitis were present in 27 patients (87.1%). In terms of laboratory values, white blood cell counts >10 × 10(9)/L occurred in 17 patients (54.8%), and C-reactive protein levels >40 mg/L were reported in 21 patients (67.7%). The conversion rate to open surgery was 32.3% (10 patients). In 13 cases, acalculous cholecystitis was present (41.9%). The average serum creatinine level 1 year after cholecystectomy had no statistically significant differences. One patient required temporary dialysis during the postoperative period (with subsequent graft recovery), and 1 graft was lost.
  
  
  CONCLUSIONS
  Acute cholecystitis in kidney transplant recipients is a serious complication, with frequent difficulties related to evaluation and diagnosis. Because clinical signs could be very mild compared with severity of gallbladder affliction, there is little room if any for conservative treatment in these patients. We have not noticed adverse impact of acute cholecystitis on 1-year graft function.
authors: Universitätsklinik für Chirurgie, Landeskrankenhaus Salzburg-Universitätsklinikum der Paracelsus Medizinischen Privatuniversität, Salzburg, Österreich; Transplant Surgery Department, Institute for Clinical and Experimental Medicine, Prague, Czech Republic. Electronic address: vargas@centrum.cz.
authors: M
authors: M
authors: Varga
authors: Transplant Surgery Department, Institute for Clinical and Experimental Medicine, Prague, Czech Republic.
authors: M
authors: M
authors: Kudla
authors: Diabetes Centre, Institute for Clinical and Experimental Medicine, Prague, Czech Republic.
authors: L
authors: L
authors: Vargova
authors: Transplant Surgery Department, Institute for Clinical and Experimental Medicine, Prague, Czech Republic.
authors: J
authors: J
authors: Fronek
mesh_terms: D000328:Adult; D000368:Aged; D002097:C-Reactive Protein / Q000378:metabolism; D017081:Cholecystectomy, Laparoscopic / Q000379:methods*; D041881:Cholecystitis, Acute / Q000000981:diagnostic imaging / Q000601:surgery*; D061887:Conversion to Open Surgery; D005260:Female; D006085:Graft Survival; D006801:Humans; D016030:Kidney Transplantation; D007958:Leukocyte Count; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000209:etiology / Q000601:surgery; D006435:Renal Dialysis; D012189:Retrospective Studies; D014463:Ultrasonography; D055815:Young Adult
chemical_list: D002097:C-Reactive Protein