E-ISSN 2587-0610
Treatment of acute cholecystitis and risk factors for mortality in hemodialysis patients [Laparosc Endosc Surg Sci ]
Laparosc Endosc Surg Sci . 2020; 27(4): 220-228 | DOI: 10.14744/less.2020.59354

Treatment of acute cholecystitis and risk factors for mortality in hemodialysis patients

Aydın Aktaş1, Cüneyt Kayaalp2, Mehmet Uluşahin3, Arif Burak Çekiç3, Müfit Şansal2, Kutay Sağlam2, Serdar Türkyilmaz3, Fatih Sümer2
1Department of Gastrointestinal Surgery, University of Medical Sciences, Kanuni Training and Research Hospital, Trabzon, Turkey
2Department of Gastrointestinal Surgery, Inonu University, Malatya, Turkey
3Department of Surgery, Karadeniz Technical Universtiy, Trabzon, Turkey

INTRODUCTION: There have been few studies on the treatment of acute cholecystitis (AC) in hemodialysis (HD) patients. The aim of this study was to investigate the risk factors for mortality in HD patients who developed AC, and to compare the results of treatment.
METHODS: The records of HD patients who developed AC between 2009 and 2019 were analyzed retrospectively. The diagnosis and severity of AC was made according to Tokyo Guideline (TG) 18. The American Society of Anesthesiologists (ASA) scores were used for surgical risk. The Charlson comorbidity index (CCI) was used for comorbid conditions of patients. Risk factors were investigated for mortality. Medical treatment and cholecystectomy results were compared.
RESULTS: Thirty-four patients were included in the study. Mortality occurred in six patients (17.6%). Age ≥65 years, an ASA IV score, a CCI ≥8, Tokyo Guideline 18 (TG 18) grade III, and blood urea nitrogen ≥60 mg/dL were increased those who died (p=0.03, p=0.001, p=0.02, p<0.001, p=0.03; respectively). According to TG 18, there was no difference between the medical treatment and cholecystectomy groups in terms of clinical success, readmission, and mortality rates (p=1.00, p=0.64, p=1.00; respectively). However, length of hospital stay was longer in the cholecystectomy group (p=0.01).
DISCUSSION AND CONCLUSION: Despite the suggestions in the TG 18, medical treatment and in-hospital early cholecystectomy can be performed with similar clinical success, readmission, and mortality rates in HD patients who develop AC.

Keywords: Acute cholecystitis, end stage renal disease, outcomes, clinical success, medical treatment, cholecystectomy, death

Aydın Aktaş, Cüneyt Kayaalp, Mehmet Uluşahin, Arif Burak Çekiç, Müfit Şansal, Kutay Sağlam, Serdar Türkyilmaz, Fatih Sümer. Treatment of acute cholecystitis and risk factors for mortality in hemodialysis patients. Laparosc Endosc Surg Sci . 2020; 27(4): 220-228

Corresponding Author: Aydın Aktaş, Türkiye
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