This article is a retrospective analysis of 54 cases of acalculous cholecystitis which were operated upon at Dept. of surgery, BNUH from Jan. 1977 to Dec. 1983. The following results were obtained.
1) Among 256 patients with non-malignant biliary tract disease who were treated surgically, an acalculous cholecystitis was found in 54 cases(21. 1%).
2) The sex ratio of male to female was 1 to 1. 6. The range in aga was from 6 to 74 years, and the prevalent age was 4th decade(38.9%).
3) The etiologic and predisposing factors were as follows. a) Parasite infections, 19 cases(35.2%).
b) Typhoid cholecystitis, 5 cases(9.3%).
c) Other abdominal inflammation, 9 cases(16.7%).
d) Biliary tract obstruction except malignant disease, 5 cases(9.3%). e) Chronic systemic diseases, 4 cases(7.4%).
f) Operation unrelated to biliary system or trauma, 1 case (1.9%). g) Unknown, 11 cases(20.4%).
4) There are no differences in symptom and sign between a calculous and an acalculous cholecystitis.
5) The important laboratory findings were leukocytosis(51. 9%), elevation of alkaline phosphatase(78.3%), and elevation of serum bilirubin level(28.3%). In differential count, eosinophilia was found in 47.4% of parasitic infections.
6) On radiologic findings, intravenous cholecystogram and ultrasonogram were most helpful for diagnosis of an acalculous cholecystitis.
7) Histopathologically, chronic cholecystitis was most common(68.5%). In 21 cases cultured of bile, B. Coli was most common.
8) A cholecystectomy was performed in 52 cases(96.3%) except 2 cases performed chocys-tostomy.
9) The wound infection and pulmonary complications were most common in postoperative complications. Overall mortality rate was 5.6%, and the causes of death were septic shock, multiple organic failures due to sepsis, and stress ulcer.
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