Please use this identifier to cite or link to this item: https://ahro.austin.org.au/austinjspui/handle/1/11305
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dc.contributor.authorNikfarjam, Mehrdad-
dc.contributor.authorNiumsawatt, Vachara-
dc.contributor.authorSethu, Arun-
dc.contributor.authorFink, Michael A-
dc.contributor.authorMuralidharan, Vijayaragavan-
dc.contributor.authorStarkey, Graham-
dc.contributor.authorJones, Robert M-
dc.contributor.authorChristophi, Christopher-
dc.date.accessioned2015-05-16T00:53:40Z
dc.date.available2015-05-16T00:53:40Z
dc.date.issued2011-06-03-
dc.identifier.citationHPB: the Official Journal of the International Hepato Pancreato Biliary Association 2011; 13(8): 551-8en_US
dc.identifier.otherPUBMEDen
dc.identifier.urihttps://ahro.austin.org.au/austinjspui/handle/1/11305en
dc.description.abstractGangrenous cholecystitis (GC) is considered a more severe form of acute cholecystitis. The risk factors associated with this condition and its impact on morbidity and mortality compared with those of non-gangrenous acute cholecystitis (NGAC) are poorly defined and based largely on findings from older studies.Patients with histologically confirmed acute cholecystitis treated in specialized units in a tertiary hospital between 2005 and 2010 were identified from a prospectively maintained database. Data were reviewed retrospectively and patients with GC were compared with those with NGAC.A total of 184 patients with NGAC and 106 with GC were identified. The risk factors associated with GC included older age (69 years vs. 57 years; P= 0.001), diabetes (19% vs. 10%; P= 0.049), temperature of >38 °C (36% vs. 16%; P < 0.001), tachycardia (31% vs. 15%; P= 0.002), detection of muscle rigidity on examination (27% vs. 12%; P= 0.01) and greater elevations in white cell count (WCC) (13.4 × 10⁹/l vs. 10.7 × 10⁹/l; P < 0.001), C-reactive protein (CRP) (94 mg/l vs. 17 mg/l; P= 0.001), bilirubin (19 µmol/l vs. 17 µmol/l; P= 0.029), urea (5.3 mmol/l vs. 4.7 mmol/l; P= 0.016) and creatinine (82 µmol/l vs. 74 µmol/l; P= 0.001). The time from admission to operation in days was greater in the GC group (median = 1 day, range: 0-14 days vs. median = 1 day, range: 0-10 days; P= 0.029). There was no overall difference in complication rates between the GC and NGAC groups (22% vs. 14%; P= 0.102). There was a lower incidence of common bile duct stones in the GC group (5% vs. 13%; P= 0.017). Gangrenous cholecystitis was associated with increased mortality (4% vs. 0%; P= 0.017), but this was not an independent risk factor on multivariate analysis.Gangrenous cholecystitis has certain clinical features and associated laboratory findings that may help to differentiate it from NGAC. It is not associated with an overall increase in complications when treated in a specialized unit.en_US
dc.language.isoenen
dc.subject.otherAdolescenten
dc.subject.otherAdulten
dc.subject.otherAgeden
dc.subject.otherAged, 80 and overen
dc.subject.otherChi-Square Distributionen
dc.subject.otherCholecystectomy, Laparoscopic.adverse effects.mortalityen
dc.subject.otherCholecystitis, Acute.diagnosis.etiology.mortality.surgeryen
dc.subject.otherFemaleen
dc.subject.otherGallbladder.pathology.surgeryen
dc.subject.otherGangreneen
dc.subject.otherHumansen
dc.subject.otherMaleen
dc.subject.otherMiddle Ageden
dc.subject.otherOdds Ratioen
dc.subject.otherPredictive Value of Testsen
dc.subject.otherProportional Hazards Modelsen
dc.subject.otherRetrospective Studiesen
dc.subject.otherRisk Assessmenten
dc.subject.otherRisk Factorsen
dc.subject.otherTime Factorsen
dc.subject.otherTreatment Outcomeen
dc.subject.otherVictoriaen
dc.subject.otherYoung Adulten
dc.titleOutcomes of contemporary management of gangrenous and non-gangrenous acute cholecystitis.en_US
dc.typeJournal Articleen_US
dc.identifier.journaltitleHPB : the Official Journal of the International Hepato Pancreato Biliary Associationen_US
dc.identifier.affiliationSurgery (University of Melbourne)en_US
dc.identifier.doi10.1111/j.1477-2574.2011.00327.xen_US
dc.description.pages551-8en
dc.relation.urlhttps://pubmed.ncbi.nlm.nih.gov/21762298en
dc.type.contentTexten_US
dc.type.austinJournal Articleen
local.name.researcherChristophi, Christopher
item.openairecristypehttp://purl.org/coar/resource_type/c_18cf-
item.cerifentitytypePublications-
item.fulltextNo Fulltext-
item.grantfulltextnone-
item.languageiso639-1en-
item.openairetypeJournal Article-
crisitem.author.deptSurgery (University of Melbourne)-
crisitem.author.deptVictorian Liver Transplant Unit-
crisitem.author.deptSurgery-
crisitem.author.deptSurgery (University of Melbourne)-
crisitem.author.deptHepatopancreatobiliary Surgery-
crisitem.author.deptSurgery-
crisitem.author.deptVictorian Liver Transplant Unit-
crisitem.author.deptSurgery (University of Melbourne)-
crisitem.author.deptHepatopancreatobiliary Surgery-
crisitem.author.deptGastroenterology and Hepatology-
crisitem.author.deptSurgery-
crisitem.author.deptHepatopancreatobiliary Surgery-
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