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Gangrenous cholecystitis in male patients:A study of prevalence and predictive risk factors
Ann Hepatobiliary Pancreat Surg 2019 Feb;23(1):34-40
Published online February 28, 2019;  https://doi.org/10.14701/ahbps.2019.23.1.34
Copyright © 2019 Korean Association of Hepato-Biliary-Pancreatic Surgery.

Carlos Augusto Gomes1, Cleber Soares Junior1, Salomone Di Saverio2, Massimo Sartelli3, Poliana Graciele de Souza Silva4, Agnes Silva Orlandi4, Thais Lacerda Heringer4, Felipe Couto Gomes5, and Fausto Catena6

1Surgery Department, Hospital Universitário Therezinha de Jesus, Faculdade de Ciências Médicas e da Saúde Juiz
de Fora (SUPREMA), Hospital Universitário da Universidade Federal de Juiz de Fora (ufjf), Juiz de Fora, Brazil,
2Cambridge University Hospitals NHS Foundation Trust, Addenbrooke’s Hospital, Cambridge, England, 3Department of Surgery, Macerata University Hospital, Macerata, Italy, 4Internal Medicine Unit, Hospital Universitário da Universidade Federal de Juiz de Fora (ufjf), 5Internal Medicine Unit, Hospital Universitário Therezinha de Jesus, Faculdade de Ciências Médicas e da Saúde Juiz de Fora (SUPREMA), Juiz de Fora, Brazil, 6Department of General Surgery, Maggiore Hospital, Parma, Italy and Department of Surgery, “Infermi” Hospital, Rimini, Italy
Received May 31, 2018; Revised June 21, 2018; Accepted June 26, 2018.
This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.
 Abstract
Backgrounds/Aims: The prevalence and risk factors of gangrenous cholecystitis in male are unknown.
Objective: To verify the prevalence and risk factors of gangrenous cholecystitis in males.
Methods: This cross-sectional study includes 95 patients (59.5±17.1 years), with clinical and histopathological diagnosis, operated laparoscopically on 2012-2016. Eligibility was decided based on the variables of age; tachycardia (>100 bpm); leukocytosis (>10,000/mm³); Murphy’s sign; gallbladder wall thickness (>4 mm); biochemical tests, morbidities (diabetes, alcoholism, smoking) and mortality. Multivariate regression, the chi-squared and Prevalent Chances Ratio (PCR) were used to define a few parameters.
Results: The prevalence of gangrenous cholecystitis in men older than 50 years was 29.3%. The risk factors for the disease were as follows: diabetes mellitus (p=0.006, RCP=4.191), leukocytosis (p=0.003), gallbladder thickness greater than 4 mm (p=0.035, RCP=3.818), which increased mortality [(p=0.04) (RCP=8.001)]. Murphy’s sign showed a negative association (p=0.002, RCP=0.204). Values close to significance were observed in relation to gamma glutamyl transferase (p=0.083, RCP=3.125) and hospital stay (p=0.061, RCP=2.765).
Conclusions: Male gender, and age older than 50 years, were correlated with a high prevalence of necrosis, higher than that reported in females. The risk factors for developing necrosis are the same as those described for female patients.
Keywords : Abdominal infections; Abdominal surgery; Cholecystectomy; Complication; Laparoscopic surgery

 

February 2019, 23 (1)