Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2022 Mar;29(3):322-328.
doi: 10.1002/jhbp.1069. Epub 2021 Nov 8.

Clinical impact of bloodstream infection on acute cholecystitis indicated for emergency cholecystectomy

Yusuke Hanabata  1 , Kenya Yamanaka  1 , Akina Shinkura  1 , Makoto Kurimoto  1 , Hikaru Aoki  1 , Kaichiro Harada  1 , Masashi Kayano  1 , Misaki Tashima  1 , Jun Tamura  1
Affiliations

Clinical impact of bloodstream infection on acute cholecystitis indicated for emergency cholecystectomy

Yusuke Hanabata et al. J Hepatobiliary Pancreat Sci. 2022 Mar.

Abstract

Background: The significance of blood culture for acute cholecystitis remains unclear.

Methods: A retrospective cohort study was conducted on patients who underwent emergency cholecystectomy at Hyogo Prefectural Amagasaki General Medical Center to examine the clinical impact of bloodstream infection (BSI), focusing on the association of BSI with bactibilia and severity grade based on the Tokyo guidelines 2018 (TG18).

Results: Among 177 patients included in the study, 32 had positive and 145 had negative BSI. Significant differences were observed between the positive and negative BSI in terms of age, body mass index (BMI), the American Society of Anesthesiologists physical status (ASA-PS) and TG18 severity score. The odds ratios of BSI for patients aged ≥72 years, with a BMI of ≤21.8, an ASA-PS of ≥3E, and grade III acute cholecystitis were 3.45, 3.23, 2.43 and 4.51, respectively. In the multivariate analysis, lower BMI and grade III were significantly associated with BSI with odds ratios of 2.53 (95% confidence interval: 1.07-6.21, P = .037) and 3.03 (95% confidence interval: 1.02-8.82, P = .041). Bacterial species that could not be isolated in the bile culture alone were identified in blood culture on 10 (38.5%) of 26 patients.

Conclusions: Bloodstream infection is associated with grade III acute cholecystitis. Blood culture enables the identification of bacteria that cannot be isolated in bile culture. Blood culture should be obtained for patients with grade III acute cholecystitis who undergo emergency cholecystectomy.

Keywords: acute cholecystitis; bloodstream infection; cholecystectomy; elderly; emergencies.

PubMed Disclaimer

References

REFERENCES

    1. Kimura Y, Takada T, Kawarada Y, Nimura Y, Hirata K, Miho S, et al. Definitions, pathophysiology, and epidemiology of acute cholangitis and cholecystitis: Tokyo Guidelines. J Hepatobiliary Pancreat Sci. 2007;14:15-26.
    1. Yamashita Y, Takada T, Strasberg SM, Pitt HA, Gouma PD, Garden OJ, et al. TG13 surgical management of acute cholecystitis. J Hepatobiliary Pancreat Sci. 2013;20:89-96.
    1. Luo Y, Makepe M, Yim A, Tacey M, Bird D, Hodgson R. An Acute General Surgical Unit (AGSU) Negates the Impact of the Tokyo Guidelines 2018 (TG18) Diagnostic Criteria for the Treatment of Acute Cholecystitis. World J Surg. 2019;43:2762-9.
    1. Rice CP, Vaishnavi KB, Chao C, Jupiter D, Schaeffer AB, Jenson WR, et al. Operative complications and economic outcomes of cholecystectomy for acute cholecystitis. World J Gastroenterol. 2019;25:6916-27.
    1. Roulin D, Saadi A, Mare LD, Demartines N, Halkic N. Early versus delayed cholecystectomy for acute cholecystitis, are the 72 hours still the rule?: A randomized trial. Ann Surg. 2016;264:717-22.

LinkOut - more resources