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Acute cholecystitis in neutropenic patients
Ann Hepatobiliary Pancreat Surg 2019 Aug;23(3):234-9
Published online August 31, 2019;  https://doi.org/10.14701/ahbps.2019.23.3.234
Copyright © 2019 Korean Association of Hepato-Biliary-Pancreatic Surgery.

Uriel Clemente-Gutiérrez, German Esteban Sánchez Morales, Paulina Moctezuma Velazquez, Alexandra Rueda de León Aguirre, Jesus Morales Maza, Ismael Dominguez-Rosado, and Heriberto Medina-Franco

Department of Surgery, National Institute of Health Sciences and Nutrition Salvador Zubirán, Mexico City, Mexico
Received July 10, 2018; Revised November 10, 2018; Accepted November 15, 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 frequency of acute cholecystitis reported in neutropenic patients is between 0.4-1.65%. Clinical manifestations differ from general population as well as clinical approach, diagnosis and treatment. The aim of this work is to describe clinical characteristics, diagnostic approach, and outcomes of patients with hematological diseases that presented with neutropenia and fever associated with acute cholecystitis in a tertiary referral hospital.
Methods: We performed a retrospective analysis of patients with diagnosis of neutropenia and fever associated with acute cholecystitis in the period between January 2000 and January 2017. Quantitative variables were analyzed with mean and standard deviation, and qualitative variables with frequency and percentage.
Results: During the study period, 2007 patients presented with neutropenia and fever. Twelve of them (0.59%) had associated acute cholecystitis. The most common hematologic disease among these patients was lymphoblastic leukemia. Acute acalculous cholecystitis was diagnosed in 6 cases (50%). Eleven patients (91.6%) had a severe presentation and cholecystostomy was performed in 9 (75%) cases. The main cause of mortality was septic shock (33.3%).
Conclusions: Treatment of acute cholecystitis in patients with neutropenia must be individualized. Cholecystostomy should be considered as a bridge therapy for an interval cholecystectomy.
Keywords : Cholecystitis; Leukemia; Neutropenia

 

August 2019, 23 (3)