Gangrenous cholecystitis in male patients: A study of prevalence and predictive risk factors

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. (Ann Hepatobiliary Pancreat Surg 2019;23:34-40)