Advanced gallbladder inflammation is a risk factor for gallbladder perforation in patients with acute cholecystitis

World Journal of Emergency Surgery : WJES
Stefan JansenPeter C Ambe

Abstract

Acute perforated cholecystitis (APC) is probably the most severe benign gallbladder pathology with high rates of morbidity and mortality. The cause of APC has not been fully understood. We postulated that APC is a complication of advanced gallbladder inflammation. The aim of this study was to investigate the extent of gallbladder inflammation in patients with APC. Patients with intraoperative and histopathologic diagnosis of APC were compared with cases with acute cholecystitis without perforation with respect to the extent of inflammation on histopathology as well as surgical outcomes. Fifty patients with APC were compared to 150 cases without perforation. Advanced age > 65 years and elevated CRP were confirmed on multivariate analysis as independent risk factors for APC. Advanced gallbladder inflammation was seen significantly more often in patients with APC (84.0 vs. 18.7%). Surgery lasted significantly longer 131.3 ± 55.2 min vs. 100.4 ± 47.9 min; the rates of conversion (22 vs. 4%), morbidity (24 vs. 7%), and mortality (8 vs. 1%) were significantly higher in patients with APC. ICU management following surgery was needed significantly more often in the APC group (56 vs. 15%), and the overall length of stay (11.2 ± 12.0 days...Continue Reading

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Citations

Dec 26, 2018·The British Journal of Surgery·K SøreideS J Wigmore
Jan 23, 2021·Journal of the American College of Surgeons·Laura K KreckoHee Soo Jung
Jun 11, 2021·Emergency Radiology·Kiran MadduCarrie Hoff
Jun 26, 2021·Annals of Emergency Medicine·Angela UgoretsJoshua S Rempell
Jul 2, 2021·BMJ Case Reports·Jasmine CraneMichael Lewis

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