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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.
Objective:
This research was performed to determine the risk factors for gallbladder gangrene in acute acalculous cholecystitis patients and to assess the predictive ability of inflammatory markers.
Methods:
The study included 226 acute acalculous cholecystitis patients who underwent laparoscopic cholecystectomy within 72 h of onset. The receiver operating characteristic curves were employed to determine the optimal cut-off, specificity, and sensitivity of inflammatory markers in predicting gangrenous cholecystitis. Logistic regression analysis was conducted to ascertain the independent risk factors associated with gallbladder gangrene.
Results:
The incidence rate of gallbladder gangrene in acute acalculous cholecystitis was 45.1% (102/226). Compared with other inflammatory markers, the systemic immune-inflammation index (SII) demonstrated superior predictive validity (vs. CRP, p = 0.021; vs. WBC, p < 0.001; vs. PCT, p = 0.004; vs. NLR, p < 0.001; vs. PLR, p < 0.001). The results of the logistic regression analysis revealed that platelet, PCT, SII, D-dimer, CA19-9, gallbladder enlargement, and gallbladder effusion were independent risk factors.
Conclusion:
This study found that platelet, PCT, SII, D-dimer, CA19-9, gallbladder enlargement, and gallbladder effusion were independent risk factors for gallbladder gangrene in acute acalculous cholecystitis. SII could serve as a novel, straightforward, and potent predictive indicator for gallbladder gangrene in acute acalculous cholecystitis.
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