Gangrenous cholecystitis: mortality and risk factors

• Published in: International surgery Vol. 100; no. 2; pp. 254 - 260
• Main Authors: Önder, Akın, Kapan, Murat, Ülger, Burak Veli, Oğuz, Abdullah, Türkoğlu, Ahmet, Uslukaya, Ömer
• Format: Journal Article
• Language: English
• Published: Italy The International College of Surgeons, World Federation of General Surgeons and Surgical Specialists, Inc 01.02.2015
• Subjects: Adult; Aged; Cholecystitis - mortality; Cholecystitis - pathology; Cholecystitis - surgery; Cholelithiasis - complications; Female; Gangrene - pathology; Hepatobiliary & Pancreatic Surgery; Hospitalization; Humans; Leukocyte Count; Male; Middle Aged; Retrospective Studies; Risk Factors; Surgical Wound Infection - complications; Time Factors; Young Adult; Cholecystectomy; mortality; Gangrenous cholecystitis
• ISSN: 0020-8868; 2520-2456
• DOI: 10.9738/INTSURG-D-13-00222.1

As a serious complication of cholelithiasis, gangrenous cholecystitis presents greater mortality than noncomplicated cholecystitis. The aim of this study was to specify the risk factors on mortality. 107 consecutive patients who underwent surgery due to gangrenous cholecystitis between January 1997 and October 2011 were investigated retrospectively. The study included 60 (56.1%) females and 47 (43.9%) males, with a mean age of 60.7 ± 16.4 (21-88) years. Cardiovascular diseases were the most frequently accompanying medical issues (24.3%). Thirty-six complications (33.6%) developed in 29 patients, and surgical site infection was proven as the most common. Longer delay time prior to hospital admission, low white blood cell count, presence of diabetes mellitus, higher blood levels of aspartate aminotransferase, alanine aminotransferase, alkaline phosphatase and total bilirubin, pericholecystic fluid in abdominal ultrasonography, and conversion from laparoscopic surgery to open surgery were identified as risk factors affecting mortality (P < 0.001, P = 0.001, P = 0.044, P = 0.005, P = 0.049, P = 0.009, P = 0.022, P = 0.011, and P = 0.004, respectively). Longer delay time prior to hospital admission and low white blood cell count were determined as independent risk factors affecting mortality.