New Diagnostic and Predisposing Parameters for Acute Acalculous Cholecystitis

Abstract

The purpose of this study is to examine the prevalence and diagnostic criteria of acute acalculous cholecystitis patients at Gulhane Training and Research Hospital and investigate etiopathogenesis and treatment outcomes. Filed data of all patients treated at the clinic for acute cholecystitis during 2016-2019 was analyzed. The demographic and clinicopathologic characteristics, diagnostic and operative parameters and gallbladder histopathology findings of the patients were examined. The patients diagnosed with acute calculous cholecystitis and acute acalculous cholecystitis was compared as 2 groups. Nine (4.6 %) of the 197 patients were diagnosed with acute cholecystitis and the rest with acute acalculous cholecystitis. The mean ages of the acute acalculous cholecystitis and acute calculous cholecystitis groups were 64.9 and 57.3 y, respectively. No predisposing factors could be found in any acute acalculous cholecystitis patient. While there was no significant difference between both the groups in terms of age, alanine aminotransferase, aspartate aminotransferase, white blood cell count, gallbladder distension, gallbladder wall thickness, and hospitalization duration, a significant difference was found in the acute acalculous cholecystitis group’s pericholecystic fluid and C-reactive protein levels. Consequently, even if there are no predisposing factors, clinicians should keep in mind that acute acalculous cholecystitis may be observed especially in patients aged 60 y or above with presence of pericholecystic fluid and high C-reactive protein levels. In these patients, if they are surgically suitable, early cholecystectomy would have positive prognosis.