Risk Factors of Gangrenous Cholecystitis in Patients with Acute Cholecystitis: A Cross-Sectional Study

Abstract

Introduction: The aim of this study was to determine factors affecting the development of acute cholecystitis toward gangrenous cholecystitis in an Iranian society.Materials and Methods: In this cross-sectional study, all patients who underwent cholecystectomy in the educational hospitals of Khorramabad from August 2013 to August 2016 were included in the study regardless of their age range. The data collected in each patient included demographic data, underlying illnesses, positive history and physical examination prior to surgery, early laboratory findings and preoperative imaging findings. Finally, patients were divided into two groups of acute Cholecystitis and Gangrenous Cholecystitis based on pathological findings after cholecystectomy. The data was finally analyzed using SPSS software.Results: 51 patients were examined during the study. Histological studies indicated the presence of microscopic evidence of acute cholecystitis in all patients, of which 19 had histological evidence of Gangrenous Cholecystitis. In this study, nine variables that could be effective on the prognosis of acute cholecystitis and its progression toward the Gangrenous Cholecystitis were identified. These variables included age, WBC count, diabetes mellitus and coronary artery disease, fluid accumulation around gallbladder, aspartate aminotransferase, alanine aminotransferase, alkaline phosphatase, and lipase. Finally, multivariate analysis was performed using logistic regression. It was found that the age of ≥51 was effective in the development of diabetes mellitus.Conclusion: In this study, it was observed that high age, diabetes mellitus and leukocytosis could lead to the development of acute cholecystitis toward Gangrenous Cholecystitis, a finding that requires more extensive studies with more sample size.