Role of laparoscopic cholecystectomy in the management of gangrenous cholecystitis

Habib, Fahim; Kolachalam, Ram B; Khilnani, Rubi; Preventza, Ourania; Mittal, Vijay K.

doi:10.1016/s0002-9610(00)00525-0

Cited by 88 publications

(67 citation statements)

References 15 publications

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“…There was no mortality in our series, where as Rehan et al 13 reported 4 major complications and one mortality in their series. The difficulties that we encountered in dissection in the area of calot's triangle are more or less the same as mentioned by other similar studies 3,15 , duration of surgery was not significantly prolonged and the outcome in terms of morbidity and hospital stay was significantly better in patients in whom laparoscopic cholecystectomy was successful 16,17 20,21 , and nonrandomized studies 15,22 , have been published, documenting the emergency use of laparoscopic cholecystectomy for acute cholecystitis. In these studies laparoscopic cholecystectomy has been proven to be a feasible and safe treatment for acute cholecystitis.…”

Section: Diagnosis Empyema Gall Bladder Gangrenous Gall Bladdersupporting

confidence: 73%

Laparoscopic Cholecystectomy in Patients with Emphysematous and Gangrenous Cholecystitis: An Experience at Khwaja Yunus Ali Medical College & Hospital, Enayetpur, Sirajgonj.

Hossain¹,

Biswas²,

Rahman³

et al. 2017

KYAMC j.

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Section: Diagnosis Empyema Gall Bladder Gangrenous Gall Bladdersupporting

confidence: 73%

Laparoscopic Cholecystectomy in Patients with Emphysematous and Gangrenous Cholecystitis: An Experience at Khwaja Yunus Ali Medical College & Hospital, Enayetpur, Sirajgonj.

Hossain¹,

Biswas²,

Rahman³

et al. 2017

KYAMC j.

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“…5, 18 Contini et al 8 reported that delayed admission was an important criterion in the development of GC. Eldar et al 17 reported worsening macroscopic alterations in the case of hospital admissions later than 48 hours.…”

Section: Discussionmentioning

confidence: 99%

Gangrenous Cholecystitis: Mortality and Risk Factors

Önder

Kapan

Ülger

et al. 2015

International Surgery

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As a serious complication of cholelithiasis, gangrenous cholecystitis presents greater mortality than noncomplicated cholecystitis. The aim of this study was to specify the risk factors on mortality. 107 consecutive patients who underwent surgery due to gangrenous cholecystitis between January 1997 and October 2011 were investigated retrospectively. The study included 60 (56.1%) females and 47 (43.9%) males, with a mean age of 60.7 6 16.4 (21-88) years. Cardiovascular diseases were the most frequently accompanying medical issues (24.3%). Thirty-six complications (33.6%) developed in 29 patients, and surgical site infection was proven as the most common. Longer delay time prior to hospital admission, low white blood cell count, presence of diabetes mellitus, higher blood levels of aspartate aminotransferase, alanine aminotransferase, alkaline phosphatase and total bilirubin, pericholecystic fluid in abdominal ultrasonography, and conversion from laparoscopic surgery to open surgery were identified as risk factors affecting mortality (P , 0.001, P ¼ 0.001, P ¼ 0.044, P ¼ 0.005, P ¼ 0.049, P ¼ 0.009, P ¼ 0.022, P ¼ 0.011, and P ¼ 0.004, respectively). Longer delay time prior to hospital admission and low white blood cell count were determined as independent risk factors affecting mortality.

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“…GC is associated with a significantly greater morbidity and mortality when compared to uncomplicated acute cholecystitis [7]. In spite of its grave prognosis, the diagnosis of GC can be elusive, both clinically and biochemically, with 48% of patients demonstrating histologically proven GC displaying no evidence to suggest this disease process pre-operatively.…”

Section: Discussionmentioning

confidence: 99%

“…There is controversy regarding the best surgical approach for GC. Some surgeons would opt for open cholecystectomy for most men over the age of 60 years who have significant comorbidity, large gallstones and a raised bilirubin level; however, in the hands of an experienced laparoscopic surgeon, laparoscopic cholecystectomy can be used safely and successfully in patients with GC [7].…”

Section: Discussionmentioning

confidence: 99%

Asymptomatic Gangrenous Cholecystitis Discovered During Elective Laparoscopic Cholecystectomy

2014

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Gangrenous cholecystitis (GC) is a serious complication of acute cholecystitis. It is associated with significant morbidity and mortality. A male with type 2 diabetes mellitus had been treated for acute cholecystitis and discharged home. The patient was admitted electively for a laparoscopic cholecystectomy 6 weeks post discharge at which time he was entirely asymptomatic. Intra-operatively the gallbladder was found to be necrotic but it was removed laparoscopically and without complication. Acute cholecystitis is the most common complication of cholelithiasis occurring in approximately 1-2% of asymptomatic patients annually; however, in approximately 2-29.6% of patients, the disease processes to GC. GC is associated with a significant morbidity and mortality; however, in spite of its grave prognosis, its diagnosis can be elusive both clinically and biochemically. Many factors have been implicated in the formation of GC, including diabetes mellitus, age ≥ 51 years, male sex, leucocytosis (WCC > 15 × 10 9 ) and a high CRP. Complications associated with GC include perforation, which has been reported to occur in up to 10% of cases of acute cholecystitis. When managing a patient with acute cholecystitis, a high index of suspicion is essential for the possibility of GC, especially in a diabetic and elderly patient even if the patient appears to be improving clinically and in the presence of normalizing laboratory investigations. There is a need to consider early or emergency cholecystectomy in these patients due to the high risk of gangrenous transformation with possibility of gallbladder perforation and a resultant increased morbidity and mortality.

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Role of laparoscopic cholecystectomy in the management of gangrenous cholecystitis

Cited by 88 publications

References 15 publications

Laparoscopic Cholecystectomy in Patients with Emphysematous and Gangrenous Cholecystitis: An Experience at Khwaja Yunus Ali Medical College & Hospital, Enayetpur, Sirajgonj.

Laparoscopic Cholecystectomy in Patients with Emphysematous and Gangrenous Cholecystitis: An Experience at Khwaja Yunus Ali Medical College & Hospital, Enayetpur, Sirajgonj.

Gangrenous Cholecystitis: Mortality and Risk Factors

Asymptomatic Gangrenous Cholecystitis Discovered During Elective Laparoscopic Cholecystectomy

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