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Predictive Factors for the Development of Gallbladder Necrosis
Sandeep Maharajh1, Joshua Brown1, Jakub Chmelo1
1Northern Oesophago-Gastric Unit, Newcastle upon Tyne Hospitals NHS Foundation Trust, Newcastle upon Tyne, GBR.
Cureus
|October 1, 2024
Summary
Elevated white cell count, C-reactive protein, and smoking predict gallbladder necrosis in acute cholecystitis patients. Early identification aids aggressive management and timely surgery for better outcomes.
Area of Science:
- Gastroenterology
- Surgical Pathology
- Epidemiology
Background:
- Acute cholecystitis is a common gallstone complication.
- Gallbladder necrosis increases morbidity and mortality risks.
- Identifying necrosis predictors is crucial for patient management.
Purpose of the Study:
- To identify risk factors predicting gallbladder necrosis in acute cholecystitis.
Main Methods:
- Retrospective review of 163 patients undergoing emergency cholecystectomy.
- Histopathological examination for gallbladder necrosis diagnosis.
- Multivariable logistic regression to determine predictive factors.
Main Results:
- 26% of patients (43/163) had gallbladder necrosis.
- Elevated white cell count (WCC), C-reactive protein (CRP), and smoking status independently predicted necrosis.
- Age, BMI, diabetes, and ASA grade were not associated with necrosis.
Conclusions:
- Higher WCC, CRP, and active smoking are key risk factors for gallbladder necrosis.
- Early identification of these factors is vital for prompt, aggressive management.
- Timely surgical intervention guided by risk factors improves patient outcomes.
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