Ann Hepatobiliary Pancreat Surg.  2019 Aug;23(3):234-239. 10.14701/ahbps.2019.23.3.234.

Acute cholecystitis in neutropenic patients

• Clemente-Gutiérrez U
• Sánchez Morales GE
• Moctezuma Velazquez P
• Rueda de León Aguirre A
• Morales Maza J
• Dominguez-Rosado I
• Medina-Franco H

• KMID: 2456020
• DOI: http://doi.org/10.14701/ahbps.2019.23.3.234

Abstract

BACKGROUNDS/AIMS
The frequency of acute cholecystitis reported in neutropenic patients is between 0.4-1.65%. Clinical manifestations differ from general population as well as clinical approach, diagnosis and treatment. The aim of this work is to describe clinical characteristics, diagnostic approach, and outcomes of patients with hematological diseases that presented with neutropenia and fever associated with acute cholecystitis in a tertiary referral hospital.
METHODS
We performed a retrospective analysis of patients with diagnosis of neutropenia and fever associated with acute cholecystitis in the period between January 2000 and January 2017. Quantitative variables were analyzed with mean and standard deviation, and qualitative variables with frequency and percentage.
RESULTS
During the study period, 2007 patients presented with neutropenia and fever. Twelve of them (0.59%) had associated acute cholecystitis. The most common hematologic disease among these patients was lymphoblastic leukemia. Acute acalculous cholecystitis was diagnosed in 6 cases (50%). Eleven patients (91.6%) had a severe presentation and cholecystostomy was performed in 9 (75%) cases. The main cause of mortality was septic shock (33.3%).
CONCLUSIONS
Treatment of acute cholecystitis in patients with neutropenia must be individualized. Cholecystostomy should be considered as a bridge therapy for an interval cholecystectomy.

Keyword

Cholecystitis; Leukemia; Neutropenia

MeSH Terms

Acalculous Cholecystitis
Cholecystectomy
Cholecystitis
Cholecystitis, Acute*
Cholecystostomy
Diagnosis
Fever
Hematologic Diseases
Humans
Leukemia
Mortality
Neutropenia
Precursor Cell Lymphoblastic Leukemia-Lymphoma
Retrospective Studies
Shock, Septic
Tertiary Care Centers

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