Prediction of extensive necrotic change in acute gangrenous cholecystitis View Full Text


Ontology type: schema:ScholarlyArticle     


Article Info

DATE

2022-05-14

AUTHORS

Atsushi Kohga, Kenji Suzuki, Takuya Okumura, Akihiro Makino, Kimihiro Yamashita, Jun Isogaki, Akihiro Kawabe, Katsuaki Muramatsu, Taizo Kimura

ABSTRACT

PurposeGangrenous cholecystitis (GC) is a severe type of acute cholecystitis that implies higher mortality and morbidity rates than uncomplicated cholecystitis. The characteristics of GC are various for each case. However, preoperative predictors of GC with extensive necrotic change have not been investigated well.MethodsA total of 239 patients who were pathologically diagnosed with GC underwent laparoscopic cholecystectomy at our hospital between January 2013 and December 2021. Of these, 135 patients were included in this study and were subdivided into the extensive necrosis group (patients with necrotic change extending to the neck of the gallbladder, n = 18) and the control group (patients with necrotic change limited to the fundus or body, not extending to the neck, n = 117) according to each operation video. Patient characteristics and perioperative factors predicting extensive necrotic change were investigated.ResultsPericholecystic fat stranding (83.3 vs. 53.8%, p = 0.018) and absence of wall enhancement on preoperative CT images (50.0 vs. 24.7%, p = 0.026) were significantly associated with extensive necrosis. Seven of 18 patients in the extensive necrosis group showed necrotic changes beyond the infundibulum. The absence of wall enhancement on preoperative CT images (71.4 vs. 28.8%, p = 0.018) was significantly associated with necrotic changes beyond the infundibulum.ConclusionsPericholecystic fat stranding and absence of wall enhancement on preoperative enhanced CT are predictors of extensive necrotic change in patients with GC. In addition, the absence of wall enhancement also predicts the presence of necrotic changes beyond the infundibulum. More... »

PAGES

723-728

Identifiers

URI

http://scigraph.springernature.com/pub.10.1007/s10140-022-02055-z

DOI

http://dx.doi.org/10.1007/s10140-022-02055-z

DIMENSIONS

https://app.dimensions.ai/details/publication/pub.1147887178

PUBMED

https://www.ncbi.nlm.nih.gov/pubmed/35567634


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