M. Nikfarjam MD, PhD, FRACS; K. Manya MBBS; M. A. Fink MBBS, FRACS; A. K. Hadj MBBS; V. Muralidharan MBBS, PhD, FRACS; G. Starkey MBBS, FRACS; R. M. Jones MBChB, FRACS, FACS; C. Christophi MD, FACS, FRCS, FRACS.
Outcomes of patients with histologically proven acute acalculous cholecystitis
Article first published online: 3 SEP 2012
© 2012 The Authors. ANZ Journal of Surgery © 2012 Royal Australasian College of Surgeons
ANZ Journal of Surgery
Volume 82, Issue 12, pages 918–922, December 2012
How to Cite
Nikfarjam, M., Manya, K., Fink, M. A., Hadj, A. K., Muralidharan, V., Starkey, G., Jones, R. M. and Christophi, C. (2012), Outcomes of patients with histologically proven acute acalculous cholecystitis. ANZ Journal of Surgery, 82: 918–922. doi: 10.1111/j.1445-2197.2012.06202.x
- Issue published online: 27 NOV 2012
- Article first published online: 3 SEP 2012
- Manuscript Accepted: 20 MAR 2012
- acalculous acute cholecystitis;
Acute acalculous cholecystitis (AAC) is traditionally described in the setting of critical illness, where the diagnosis is based on clinical assessment and imaging criteria. Very few studies have assessed the features and outcomes of AAC in patients treated by cholecystectomy.
Patients with histologically confirmed acute cholecystitis treated in a specialized unit in a tertiary hospital between 2005 and 2011 were identified from prospectively maintained database. Retrospective review of data was undertaken and patients with AAC were compared with those patients with acute cholecystitis and confirmed gallstones.
AAC was identified in 35 of 412 (8.5%) patients with acute cholecystitis. These patients were older (69 years versus 61 years; P = 0.004) and were more likely to be febrile (46% versus 21%; P = 0.001) and hypotensive (23% versus 5%; P < 0.001) at initial presentation. There was a higher incidence of chronic obstructive airways disease (COAD) in the AAC group (26% versus 6%; P < 0.001). Other co-morbidities were similar among the groups. Operative outcomes were similar between the groups. There were no overall differences in postoperative complications between AAC and calculous acute cholecystitis patients (17% versus 16%; P = 0.063). However, the postoperative length of stay was higher in the AAC group (5 days versus 3 days; P = 0.026).
AAC more commonly occurs in older patients and those with COAD. The operative outcomes and complications of AAC treated by cholecystectomy are similar to cases of acute calculous cholecystitis.