Clinical Predictive Factors for Acute Gangrenous Cholecystitis

ABSTRACT

PURPOSE: The postoperative morbidity and mortality for acute gangrenous cholecystitis (AGC) are higher than for acute nongangrenous cholecystitis (ANGC). However, preoperative predictive factors for the outcome of gangrenous cholecystitis have not been identified. The goal of this study was to determine the preoperative clinical predictive factors for the outcome of surgical treatment for acute gangrenous cholecystitis. METHODS: From January 2005 to December 2006, the medical records of 173 patients who underwent laparoscopic cholecystectomy for acute cholecystitis were reviewed and analyzed retrospectively. RESULTS: Among 173 patients with acute cholecystits, 57 (32.9%) had pathologically confirmed gangrenous cholecystits. Six variables were found to be associated with gangrenous cholecystits by univariate analysis: an age > or = 55 years, the presence of associated diseases, hypertension, fever (> or =37 degrees), an increased white blood cell count (> or = 15,450/mm3) and glucose. Four variables were identified that were associated with gangrenous cholecystits by multivariate analysis: an age > or = 55 years, the presence of associated diseases, hypertension, and an increased white blood cell count (> or =15450/mm3). CONCLUSION: The results of this study suggest that patients with an age > or = 55 years, the presence of associated diseases, hypertension, and an increased white blood cell count (> or =15450/mm3) have an increased risk of gangrenous cholecystitis and require immediate surgery.