Introduction: Gangrenous cholecystitis (GC) is difficult to diagnose preoperatively. A delay in diagnosis leads to increased complications. A high index of suspicion followed by early surgery leads to increased chances of laparoscopic cholecystectomy with decreased morbidity and early discharge. The aim of the study was to study the demographics, contrast-enhanced computerized tomography (CECT) and magnetic resonance imaging (MRI) findings, type of procedure (laparoscopic/open), and the outcome of the patients.
Materials and methods: A retrospective study was undertaken on GC patients. Patients were divided into three groups depending upon the type of surgery (LC, OC, LC-OC). Patient demographics, comorbidities, preoperative biochemical, CECT, MRI findings, time taken from admission to surgery, type of surgery, post-op complications, and length of stay were compared.
Results: During a 5-year period, a total of 55 patients were diagnosed with GC. Of these cases, 47.27% underwent laparoscopic cholecystectomy (LC), 41.82% were treated with OC, and the remaining 10.91% had a combination of LC and OC. The median age of the patients was 58.12 ± 16.66 years, 65.65 ± 11.13, 58.16 ± 12.79 years in LC, OC, LC-OC groups respectively. The male to female ratio was 1.4:1. Approximately 45.45% of the individuals had hypertension, while 41.81% were diagnosed with diabetes. Additionally, 16.36% of the patients were found to have coronary artery disease (CAD), and 14.54% were undergoing antiplatelet therapy. Moreover, leukocytosis was observed in 40% of the patient cases. The conversion rate from laparoscopic procedure to open procedure was 18.75%. Postoperative morbidity was seen in 18.18% of patients. Average hospital and ICU stay in the LC group was the shortest (3.76 ± 1.94 days, 0.53 ± 1.38 days respectively). Hospital and ICU stay in the OC group was 10.8 ± 5.76 and 2.43 ± 5.35 days respectively. The average stay of the LC-OC group in the hospital and ICU was 9 ± 6.75 and 3.5 ± CECT 68 days. The p-value for hospital and ICU stay was 0.0001 and 0.0179 respectively.
Conclusion: A high index of suspicion, and increased use of CECT and MRI in suspected cases followed by early LC leads to favorable outcomes in GC.
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