Characteristics and prevalence of acute cholecystitis in patients with hematologic malignancies

Abstract

BACKGROUND: Acute cholecystitis is a serious medical condition that affects patients who are hospitalized. The purpose of this study was to describe the natural history of cholecystitis in patients who have lymphoproliferative diseases and to define risk factors and predictors of poor outcome. METHODS: This is a retrospective study of patients admitted to the American University of Beirut Medical Center from January 2000 to December 2016 for chemotherapeutic treatment of hematologic malignancies and who developed cholecystitis during their hospitalization. The medical files were reviewed, and data related to demographics, management strategies and complications were collected. RESULTS: Two thousand eighty-seven patients were admitted with hematologic malignancies. The most common malignancy was non-Hodgkin’s lymphoma, 42%. One thousand three hundred sixteen (88%) patients did not have gallstones while 181 (12%) had gallstones. Twenty-six out of the 181 patients who had gallstones (14%) developed cholecystitis while on chemotherapeutic treatment and eleven patients (6%) developed biliary colic requiring cholecystectomy. All mortality cases were in the non-surgical group and 70% were neutropenic at diagnosis. Cholecystectomies were performed more (P=0.002) in cases of calculous cholecystitis. Patients who developed acalculous cholecystitis had higher proportion of patients with fever (P=0.004), neutropenia (P=0.026), sepsis (P<0.001), need for respiratory support (P=0.015) and 30-day mortality (P=0.002). CONCLUSIONS: Development of acute calculous and acalculous cholecystitis in patients with hematologic diseases has a significant impact on the treatment course. Cholecystectomy can be safely performed for these patients and was shown to have a better outcome than medical treatment. © 2021 EDIZIONI MINERVA MEDICA.