{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,12,11]],"date-time":"2025-12-11T03:03:03Z","timestamp":1765422183911,"version":"3.44.0"},"reference-count":18,"publisher":"BMJ","issue":"1","license":[{"start":{"date-parts":[[2020,5,6]],"date-time":"2020-05-06T00:00:00Z","timestamp":1588723200000},"content-version":"unspecified","delay-in-days":5,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["Trauma Surg Acute Care Open"],"accepted":{"date-parts":[[2020,4,17]]},"published-print":{"date-parts":[[2020,5]]},"abstract":"<jats:sec>\n                  <jats:title>Background<\/jats:title>\n                  <jats:p>Early cholecystectomy (EC) for acute cholecystitis (AC) is standard. Often patients with cancer are not EC candidates and require non-surgical treatments. We analyzed factors associated with non-surgical treatments and progression to interval cholecystectomy (IC).<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Materials and methods<\/jats:title>\n                  <jats:p>We performed a case\u2013control study reviewing consults for AC from 2001 to 2017 in a tertiary cancer center. Study patients had cancer, abdominal pain, and positive imaging studies. Univariate analysis and regression modeling evaluated associations between non-surgical management, resolution of AC, and IC.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>206 patients met the criteria. 20 underwent EC, 132 took antibiotics (ABX), and were treated with 54 percutaneous cholecystostomy tubes (PCTs). AC resolution was higher with PCT versus ABX (94% vs. 80%, p=0.02). Univariate analysis revealed higher absolute neutrophil counts (ANCs) and longer length of stay in PCT, and logistic regression revealed independent associations of abdominal malignancy (OR=6.66, 95%\u2009CI 1.36 to 32.6, p=0.09), abdominal radiation (OR=0.09, 95%\u2009CI 0.02 to 0.53, p&lt;0.01), and PCT with resolution of AC (OR=4.89, 95%\u2009CI 1.18 to 20.2, p=0.01). IC rate was 43%, and median time to IC after was 45 to 67 days. Multivariate analysis revealed nausea\/vomiting and increasing platelets are independently associated with IC. Recent chemotherapy increases odds of IC in the presence of rising ANC (OR=1.14, 95%\u2009CI 1.00 to 1.30, p=0.05).<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusion<\/jats:title>\n                  <jats:p>PCT has a higher success rate of resolving AC than ABX. Abdominal malignancy increases odds of resolution; abdominal radiation decreases odds. Nausea\/vomiting and recent chemotherapy, coupled with rising ANC are associated with IC, but less than 50% of patients return for operation. PCT may not be a bridge to IC in our population.<\/jats:p>\n                  <jats:p>\n                     <jats:bold>Level of evidence<\/jats:bold> II.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1136\/tsaco-2020-000439","type":"journal-article","created":{"date-parts":[[2020,5,7]],"date-time":"2020-05-07T07:49:27Z","timestamp":1588837767000},"page":"e000439","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":6,"title":["Use of non-operative treatment and interval cholecystectomy for cholecystitis in patients with cancer"],"prefix":"10.1136","volume":"5","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-7636-7077","authenticated-orcid":false,"given":"David","family":"Santos","sequence":"first","affiliation":[{"name":"Department of Surgical Oncology, UTMDACC, Houston, Texas, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Celia 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