Acute Cholecystitis Management in Uruguay: Retrospective Study on Surgical Outcomes and Risk Factors.

INTRODUCTION

Gallstones affect up to 29% of the global population, with 10%-30% of patients presenting with acute cholecystitis as their initial manifestation. This study aims to characterize the demographic and clinical profile of patients undergoing emergency surgical treatment for acute cholecystitis, evaluate postoperative outcomes, and identify risk factors for complications.

METHODS

A retrospective analysis was conducted on all patients admitted to the emergency department with acute cholecystitis between January 1, 2014, and July 31, 2024. Descriptive statistics were used to summarize categorical variables and continuous variables. Associations were assessed using the chi-square test, medians were compared using the Mann-Whitney U test, or median test for k samples and risk was quantified using odds ratio (OR).

RESULTS

A total of 530 patients were included. Common comorbidities included hypertension (26.4%), diabetes (13.2%), and immunosuppression (4.7%). Laboratory findings revealed median white blood cell counts of 10.5 × 103 cells/μL (interquartile range 5.5) and C-reactive protein of 10.8 mg/dL (interquartile range 77). Laparoscopic cholecystectomy was completed in 94.0% of cases, with a 1.4% conversion rate to open surgery. Postoperative complications occurred in 6.0% of patients. Significant associations were found between surgical complications and immunosuppression (OR 3.65, P = 0.041), obstructive patterns (OR 4.32, P = 0.031), age (OR 1.03, P = 0.006), time since symptom onset (OR 1.13, P = 0.014), and cholecystitis inflammation stages (P = 0.014).

CONCLUSIONS

The management of acute cholecystitis at our institution adheres to internationally accepted guidelines, with outcomes consistent with global benchmarks. This study underscores the importance of identifying risk factors for complications to optimize surgical management and improve patient outcomes.