Gangrenous cholecystitis - the lethal complication of severe acute pancreatitis(SAP)        HUANG Jie, QIN Shuai, MAO En-qiang, et al. Department of ICU, Ruijin Hospital, School of Medcine, Shanghai Jiaotong University, Shanghai 200025, China.
Corresponding author: MAO En-qiang, E-mail:maoeq@yeah.net.
Abstract    Objective    Study for the characteristics of gangrenous cholecystitis in patients with SAP to support future clinical diagnosis and treatment. Methods    Retrospectively analyze the predisposing factors, clinical characteristics, surgical intervention and prognosis of 4 gangrenous cholecystitis with SAP patients admitted in our ICU between Jan 2008 and Dec 2009. Results    4 SAP patients presented gangrenous cholecystitis with a morbidity of 5.9%. These patients presented severe sepsis, septic shock and organ dysfunction with aminotransferase and bilirubin little elevated. CT imaging showed gallbladder engorgement, wall thickening, gallstone, irregular or absent wall. Surgical interventions were performed until those patients presented severe sepsis, organic dysfunction and severe encephalopathy. One patient achieved a favorable clinical response after cholecystectomy, Clinical failure was observed in other 3 patients after gallbladder drainage, and overall end-of-treatment mortality was 2/4. Conclution    Early diagnosis and surgical intervention of gangrenous cholecystitis in the acute phase reaction of SAP was important and helpful to improve prognosis.