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The Risk Factor Analysis of Gallbladder Gangrene in Acute Acalculous Cholecystitis: A Single-Center Retrospective
Jiu-Ling Zheng1, Shuang-Quan Liu1, Yan-Han Liu2
1Department of Hepatobiliary Surgery, The Chongqing University Jiangjin Hospital, School of Medicine, Chongqing University, Chongqing, China.
Gastroenterology Research and Practice
|October 30, 2025
Summary
Gallbladder gangrene in acute acalculous cholecystitis is predicted by platelet count, PCT, SII, D-dimer, CA19-9, and gallbladder changes. The systemic immune-inflammation index (SII) shows strong predictive value.
Area of Science:
- Gastroenterology
- Surgical Oncology
- Inflammatory Diseases
Background:
- Acute acalculous cholecystitis (AAC) is a severe condition often requiring surgical intervention.
- Gallbladder gangrene is a critical complication of AAC, necessitating prompt diagnosis and management.
- Identifying predictive markers for gallbladder gangrene in AAC is crucial for improving patient outcomes.
Purpose of the Study:
- To determine risk factors for gallbladder gangrene in AAC patients.
- To evaluate the predictive performance of various inflammatory markers for gangrenous cholecystitis.
- To identify independent risk factors associated with gallbladder gangrene in AAC.
Main Methods:
- A cohort of 226 AAC patients undergoing laparoscopic cholecystectomy was analyzed.
- Receiver operating characteristic (ROC) curves were used to assess the predictive accuracy of inflammatory markers.
- Logistic regression analysis identified independent risk factors for gallbladder gangrene.
Main Results:
- The incidence of gallbladder gangrene in AAC was 45.1%.
- The systemic immune-inflammation index (SII) exhibited superior predictive validity compared to other markers (CRP, WBC, PCT, NLR, PLR).
- Independent risk factors identified include platelet count, procalcitonin (PCT), SII, D-dimer, CA19-9, gallbladder enlargement, and gallbladder effusion.
Conclusions:
- Platelet count, PCT, SII, D-dimer, CA19-9, gallbladder enlargement, and effusion are independent risk factors for gallbladder gangrene in AAC.
- SII emerges as a novel, simple, and effective predictive indicator for gallbladder gangrene in AAC patients.
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