Study on Acalculous Cholecystitis in Critically Ill Patients
P. Krishmitha
Saveetha Medical College and Hospital, Saveetha Nagar, Thandalam, Chennai, Tamil Nadu - 602105, India.
Divyan Devasir
Department of General Surgery, Saveetha Medical College and Hospital, Saveetha Nagar, Thandalam, Chennai, Tamil Nadu - 602105, India.
*Author to whom correspondence should be addressed.
Abstract
Introduction: Acute acalculous cholecystitis (AAC) may be a serious complication of critical illness. We evaluated the underlying diseases, clinical and diagnostic features, the severity of associated organ failures, and the outcome of operatively treated AAC during a mixed ICU patient population.
Aim: To study acalculous cholecystitis in critically ill patients with given data.
Methods: The data of all ICU patients who had operatively confirmed AAC during their ICU stay between 1 January 2021 and 31 July 2021 were collected from the hospital records and the intensive care unit's data management system for further analysis.
Results: Two hundred and eighteen cases of acute cholecystitis with complete charts were available for analysis. The study group included 67 critically ill patients with ASA 3 and 4, while the control group included 150 fit patients with ASA 1 and 2. Both groups were comparable with regard to preoperative data. Histopathology confirmed severe cholecystitis in a significant number of cases in the study group compared to the control group. Significantly higher rates of morbidity and mortality were recorded in the study group. Equally, significantly more patients from the study group were managed in the ICU.
Conclusion: Acute acalculous cholecystitis was associated with severe illness, infection, long ICU stay, and multiple organ failure. Mortality was related to the degree of organ failure. Prompt diagnosis and active treatment of AAC are often life-saving in these patients.
Keywords: Acute cholecystitis, gallbladder diseases, acalculous cholecystitis, surgical intensive care, patient care, critical care