|
KMID : 0371320020620030249
|
|
Journal of the Korean Surgical Society
2002 Volume.62 No. 3 p.249 ~ p.258
|
|
|
Clinical Analysis of Cholecystitis: Acalculous Cholecystitis Compared toCalculous Cholecystitis
|
|
Ko Sang-Hun
Mun Jae-Hwan
Lee Byung-Du
|
|
|
Abstract
|
|
|
Purpose: The purpose of this study was to analyse the characteristics
of acalculous cholecystitis (AC) compared with those of calculous
cholecystitis (CC), and also to find the relationship of preoperative
radiologic findings to the classification of pathological degree of
inflammation of the gallbladder in AC. Methods: Between March 1996
and June 2000 a total of 163 patients undergoing cholecystectomy for
cholecystitis were divided into group AC (21 patients) and group CC (142
patients) and retrospectively studied by analyzing clinical data.
Results: The incidence of AC among cholecystitis cases was 12.9%.
there was male preponderance in group AC whereas female preponderance in
group CC (P<0.036). The pulse rate (P＜0.02) and white blood cell count
(P<0.003) were significantly elevated in group AC. Possible etiological
factors were found in 6 cases (28%) in group AC. The rates of preoperatively
observed pericholecystic fluid collection in US (P<0.033) and dilatation of
the gallbladder in CT (0.012) were significantly higher in group AC than in
group CC. Additionally, the rate of tube drainage during surgery was
significantly higher in group AC than group CC (P<0.02). Finally, wall
thickness (P<0.05), dilatation (P<0.05) of the gallbladder in CT and the
total sum of findings in CT (P<0.01) and US (P<0.05) were strongly related
to the degree of inflammation of the gallbladder. Conclusion: The
majority of AC patients exhibit nonspecific clinical findings, often
delaying diagnosis; however, if it develops, AC tends to display more acute
and inflammatory characteristics than calculous cholecystitis. laparoscopic
surgery cannot be sucessful in cases of delayed diagnosis. US, CT and
scintigram are useful diagnostic tools if we interpretate each finding in
relation to the severity of inflammation.
|
|
|
KEYWORD
|
|
|
|
|
|
FullTexts / Linksout information
|
|
  
|
|
|
Listed journal information
|
|
  
|