Evidence map›Paper›PMID 41382140›Full record

ArticleBMC surgery2025

Predictors of acute gangrenous cholecystitis and its complications: a retrospective cohort study.

Noelle El Asmar, Chantal Rizk, Dima Malak, Mohamad Ali Ibrahim, Ayman Tawil, Martine Elbejjani, Kassem Barada

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Article in BMC surgery, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 5 papers.

0numbers the graph read from it
0cells of the map it votes in
5citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

5 citing papers in PubMed.

  1. Review
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

7 authors.

Noelle El AsmarDepartment of Internal Medicine, Division of Gastroenterology and Hepatology, American University of Beirut Medical Center, American University of Beirut, Beirut, Lebanon.
Chantal RizkDepartment of Internal Medicine, Division of Gastroenterology and Hepatology, American University of Beirut Medical Center, American University of Beirut, Beirut, Lebanon.
Dima MalakDepartment of Internal Medicine, Division of Gastroenterology and Hepatology, American University of Beirut Medical Center, American University of Beirut, Beirut, Lebanon.
Mohamad Ali IbrahimDepartment of Internal Medicine, Division of Gastroenterology and Hepatology, American University of Beirut Medical Center, American University of Beirut, Beirut, Lebanon.
Ayman TawilDepartment of pathology and Laboratory Medicine, American University of Beirut Medical Center, American University of Beirut, Beirut, Lebanon.
Martine ElbejjaniClinical Research Institute, Department of Internal Medicine, American University of Beirut, Beirut, Lebanon.
Kassem BaradaDepartment of Internal Medicine, Division of Gastroenterology and Hepatology, American University of Beirut Medical Center, American University of Beirut, Beirut, Lebanon. kb02@aub.edu.lb.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

introductionAcute gangrenous cholecystitis is a serious complication of acute cholecystitis. Predictors of its development and of its complications are not well established. The aims of our study were to determine factors related to acute gangrenous cholecystitis and its complications.

methodsThis was a retrospective cohort study of adult patients who underwent surgery for acute cholecystitis between 2010 and 2022 at a tertiary referral center. Data was collected from patients' medical records. Pathology reports were reviewed to differentiate acute gangrenous cholecystitis from acute non-gangrenous cholecystitis. Acute gangrenous cholecystitis was defined by the presence of focal or diffuse necrosis of the gallbladder wall on histopathologic examination. Demographic, clinical, laboratory and radiographic indicators were compared between acute gangrenous and acute non-gangrenous cholecystitis groups. Multivariable analysis was performed to identify factors that are associated with acute gangrenous cholecystitis and its complications.

resultsAmong 356 patients with acute cholecystitis, 121 had acute gangrenous cholecystitis and 9 were diagnosed preoperatively. Acute gangrenous cholecystitis was associated with age, male sex, comorbidities, presence of rebound tenderness, higher white blood cells count and bilirubin, and greater thickness of the gallbladder wall and gallbladder diameter. Patients with acute gangrenous cholecystitis were more likely to have sepsis and longer hospital stay. On multivariate analysis, age, male gender, gallbladder diameter and presence of pericholecystic abscess were associated with acute gangrenous cholecystitis. Age and diabetes were associated with sepsis in acute cholecystitis. Time from presentation to surgery was similar between the acute gangrenous and the non-gangrenous cholecystitis groups.

conclusionAcute gangrenous cholecystitis is common, and preoperative diagnosis is often missed. Our data suggests that considering age, co-morbidities and radiological indicators may be important to inform decision making in patients with acute cholecystitis and might facilitate timely diagnosis and optimize the medical and surgical management of those with acute gangrenous cholecystitis.

Indexed as

Cholecystitis, AcuteGallbladderAdultAgedAged, 80 and overCholecystectomyFemaleGangreneHumansMaleMiddle AgedRetrospective StudiesRisk FactorsDiabetes mellitusGangrenous cholecystitisSepsis

Identifiers

PMID41382140
PMCPMC12817750

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.