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Acalculous cholecystitis in patients undergoing bone marrow transplantation
1Department of Surgery, Stanford University Hospital, CA 94305, USA.
Objective:
To evaluate factors associated with acalculous cholecystitis in patients undergoing bone marrow transplantation and the role of repeat ultrasound examinations.
Design:
Retrospective study.
Setting:
University hospital, United States.
Subjects:
381 Patients who underwent bone marrow transplantation between 1987 and 1992.
Interventions:
Abdominal ultrasound examination (n = 134), repeat ultrasound in those considered to have acalculous cholecystitis (n = 8), and acute cholecystectomy (n = 5).
Results:
14 Patients (4%) with acalculous cholecystitis were identified. The 8 who had had liver tissue examined also had veno-occlusive disease of the liver. It was possible to follow progressing or resolving acalculous cholecystitis by repeat ultrasound examinations. 4 Of the 5 patients treated surgically survived, compared with 3 of the 9 not operated on.
Conclusions:
Acalculous cholecystitis was associated with veno-occlusive disease of the liver. Repeat ultrasound examinations were valuable in showing progressing or resolving acalculous cholecystitis and may guide treatment. Cholecystectomy seems to be a safe procedure for acalculous cholecystitis in patients undergoing bone marrow transplantation.