<?xml version="1.0" encoding="ISO-8859-1"?><article xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance">
<front>
<journal-meta>
<journal-id>2444-054X</journal-id>
<journal-title><![CDATA[Cirugía y cirujanos]]></journal-title>
<abbrev-journal-title><![CDATA[Cir. cir.]]></abbrev-journal-title>
<issn>2444-054X</issn>
<publisher>
<publisher-name><![CDATA[Academia Mexicana de Cirugía A.C.]]></publisher-name>
</publisher>
</journal-meta>
<article-meta>
<article-id>S2444-054X2019000400443</article-id>
<article-id pub-id-type="doi">10.24875/ciru.19000706</article-id>
<title-group>
<article-title xml:lang="es"><![CDATA[Factores predictores para el diagnóstico de la colecistitis aguda gangrenosa]]></article-title>
<article-title xml:lang="en"><![CDATA[Predicting factors for the diagnosis of gangrene acute cholecystitis]]></article-title>
</title-group>
<contrib-group>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Real-Noval]]></surname>
<given-names><![CDATA[Héctor]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Fernández-Fernández]]></surname>
<given-names><![CDATA[Jénnifer]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Soler-Dorda]]></surname>
<given-names><![CDATA[Guillermo]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
</contrib-group>
<aff id="Af1">
<institution><![CDATA[,Hospital de Laredo Servicio de Cirugía General y del Aparato Digestivo ]]></institution>
<addr-line><![CDATA[Laredo ]]></addr-line>
<country>España</country>
</aff>
<aff id="Af2">
<institution><![CDATA[,Hospital San Agustín Servicio de Neurología ]]></institution>
<addr-line><![CDATA[Avilés Asturias]]></addr-line>
<country>España</country>
</aff>
<pub-date pub-type="pub">
<day>00</day>
<month>08</month>
<year>2019</year>
</pub-date>
<pub-date pub-type="epub">
<day>00</day>
<month>08</month>
<year>2019</year>
</pub-date>
<volume>87</volume>
<numero>4</numero>
<fpage>443</fpage>
<lpage>449</lpage>
<copyright-statement/>
<copyright-year/>
<self-uri xlink:href="http://www.scielo.org.mx/scielo.php?script=sci_arttext&amp;pid=S2444-054X2019000400443&amp;lng=en&amp;nrm=iso"></self-uri><self-uri xlink:href="http://www.scielo.org.mx/scielo.php?script=sci_abstract&amp;pid=S2444-054X2019000400443&amp;lng=en&amp;nrm=iso"></self-uri><self-uri xlink:href="http://www.scielo.org.mx/scielo.php?script=sci_pdf&amp;pid=S2444-054X2019000400443&amp;lng=en&amp;nrm=iso"></self-uri><abstract abstract-type="short" xml:lang="es"><p><![CDATA[Resumen  Antecedentes: La colecistitis aguda gangrenosa (CG) debe tratarse precozmente por su alto riesgo de morbimortalidad.  Objetivo: Identificar factores clínicos, analíticos o ecográficos que permitan diagnosticar CG preoperatoriamente.  Método: Estudio de cohorte retrospectiva en el Hospital de Laredo (Cantabria, España), entre 2015 y 2017, de pacientes con diagnóstico de colecistitis aguda que hayan sido intervenidos. Se clasificó a los pacientes en dos grupos según el diagnóstico anatomopatológico: CG y colecistitis no gangrenosa (CNG). Se compararon las características demográficas, la comorbilidad, los datos analíticos y los datos ecográficos.  Resultados: Fueron operados 115 pacientes, de los cuales 32 tenían CG y 83 tenían CNG. Los pacientes con CG muestran unos valores más altos de índice de neutrófilos/linfocitos (p = 0.042) y de proteína C reactiva (PCR) (p &lt; 0.0001). La colecistitis alitiásica se asoció con mas frecuencia a la CG (24.1 vs. 7.0%; p &lt; 0.005). En el estudio multivariable, solo la PCR se muestra significativa. La PCR mostró un área bajo la curva ROC de 0.872, (intervalo de confianza del 95%: 0.797-0.946). Un punto de corte de PCR de 15.25 mg/dl tuvo una alta sensibilidad (90.6%) y un alto valor predictivo negativo (95%).  Conclusión: La PCR ayuda a identificar a los pacientes con CG para indicar una intervención quirúrgica precoz.]]></p></abstract>
<abstract abstract-type="short" xml:lang="en"><p><![CDATA[Abstract  Background: Gangrenous cholecystitis (GC) must be promptly treated for its high morbimortality. The object of our study is to identify clinical, laboratory or ultrasound factors that might us diagnose GC.  Method: A Retrospective cohort study is devised including all patients admitted to Hospital de Laredo (Cantabria, Spain) between 2015 and 2017 with the diagnose of acute cholecystitis and having been operated. Patients were classified in two groups according to pathology: GC and non-GC. We compared their demographics characteristics, comorbidities, laboratory parameters and ultrasound findings.  Results: A total of 115 patients were operated, of whom 32 had CG and 83 CNG. Neutrophil-to-lymphocyte ratio and C-reactive protein (CRP) showed significantly increased levels in GC group (p = 0.042) and CRP (p &lt; 0.0001). To CRP showed an area under the ROC curve of 0.872 (95% confidence interval: 0.797-0.946). Acalculous cholecystitis was significantly associated to GC (24.1 vs. 7%; p &lt; 0.005). In the multivariate analysis only the CPR showed as a predictive factor. A cutting point of CRP at 15.25 mg/dl, that had high sensibility (90.6%) and high negative predictive value (95%).  Conclusion: CRP helped identify patients with CG to indicate early surgical intervention.]]></p></abstract>
<kwd-group>
<kwd lng="es"><![CDATA[Colecistectomía]]></kwd>
<kwd lng="es"><![CDATA[Colecistitis aguda gangrenosa]]></kwd>
<kwd lng="es"><![CDATA[Ecografía]]></kwd>
<kwd lng="es"><![CDATA[Factores pronóstico]]></kwd>
<kwd lng="es"><![CDATA[Proteína C reactiva]]></kwd>
<kwd lng="en"><![CDATA[Acute gangrenous cholecystitis]]></kwd>
<kwd lng="en"><![CDATA[Cholecystectomy]]></kwd>
<kwd lng="en"><![CDATA[C-reactive protein]]></kwd>
<kwd lng="en"><![CDATA[Prognostic factors]]></kwd>
<kwd lng="en"><![CDATA[Ultrasound]]></kwd>
</kwd-group>
</article-meta>
</front><back>
<ref-list>
<ref id="B1">
<label>1</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Badia]]></surname>
<given-names><![CDATA[JM]]></given-names>
</name>
<name>
<surname><![CDATA[Nve]]></surname>
<given-names><![CDATA[E]]></given-names>
</name>
<name>
<surname><![CDATA[Jimeno]]></surname>
<given-names><![CDATA[J]]></given-names>
</name>
<name>
<surname><![CDATA[Guirao]]></surname>
<given-names><![CDATA[X]]></given-names>
</name>
<name>
<surname><![CDATA[Figueras]]></surname>
<given-names><![CDATA[J]]></given-names>
</name>
<name>
<surname><![CDATA[Arias-Díaz]]></surname>
<given-names><![CDATA[J]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Tratamiento quirúrgico de la colecistitis aguda. Resultados de una encuesta a los cirujanos españoles]]></article-title>
<source><![CDATA[Cirugía Española]]></source>
<year>2014</year>
<volume>92</volume>
<page-range>517-24</page-range></nlm-citation>
</ref>
<ref id="B2">
<label>2</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Asai]]></surname>
<given-names><![CDATA[K]]></given-names>
</name>
<name>
<surname><![CDATA[Watanabe]]></surname>
<given-names><![CDATA[M]]></given-names>
</name>
<name>
<surname><![CDATA[Kusachi]]></surname>
<given-names><![CDATA[S]]></given-names>
</name>
<name>
<surname><![CDATA[Matsukiyo]]></surname>
<given-names><![CDATA[H]]></given-names>
</name>
<name>
<surname><![CDATA[Saito]]></surname>
<given-names><![CDATA[T]]></given-names>
</name>
<name>
<surname><![CDATA[Ishii]]></surname>
<given-names><![CDATA[T]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Evaluating the timing of laparoscopic cholecystectomy for acute cholecystitis in an experienced center based on propensity score matching]]></article-title>
<source><![CDATA[Asian J Endosc Surg]]></source>
<year>2017</year>
<volume>10</volume>
<page-range>166-72</page-range></nlm-citation>
</ref>
<ref id="B3">
<label>3</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Borzellino]]></surname>
<given-names><![CDATA[G]]></given-names>
</name>
<name>
<surname><![CDATA[Steccanella]]></surname>
<given-names><![CDATA[F]]></given-names>
</name>
<name>
<surname><![CDATA[Mantovani]]></surname>
<given-names><![CDATA[W]]></given-names>
</name>
<name>
<surname><![CDATA[Genna]]></surname>
<given-names><![CDATA[M]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Predictive factors for the diagnosis of severe acute cholecystitis in an emergency setting]]></article-title>
<source><![CDATA[Surg Endosc]]></source>
<year>2013</year>
<volume>27</volume>
<page-range>3388-95</page-range></nlm-citation>
</ref>
<ref id="B4">
<label>4</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Fagan]]></surname>
<given-names><![CDATA[SP]]></given-names>
</name>
<name>
<surname><![CDATA[Awad]]></surname>
<given-names><![CDATA[SS]]></given-names>
</name>
<name>
<surname><![CDATA[Rahwan]]></surname>
<given-names><![CDATA[K]]></given-names>
</name>
<name>
<surname><![CDATA[Hira]]></surname>
<given-names><![CDATA[K]]></given-names>
</name>
<name>
<surname><![CDATA[Aoki]]></surname>
<given-names><![CDATA[N]]></given-names>
</name>
<name>
<surname><![CDATA[Itani]]></surname>
<given-names><![CDATA[KM]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Prognostic factors for the development of gangrenous cholecystitis]]></article-title>
<source><![CDATA[Am J Surg]]></source>
<year>2003</year>
<volume>186</volume>
<page-range>481-5</page-range></nlm-citation>
</ref>
<ref id="B5">
<label>5</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Nguyen]]></surname>
<given-names><![CDATA[L]]></given-names>
</name>
<name>
<surname><![CDATA[Fagan]]></surname>
<given-names><![CDATA[SP]]></given-names>
</name>
<name>
<surname><![CDATA[Lee]]></surname>
<given-names><![CDATA[TC]]></given-names>
</name>
<name>
<surname><![CDATA[Aoki]]></surname>
<given-names><![CDATA[N]]></given-names>
</name>
<name>
<surname><![CDATA[Itani]]></surname>
<given-names><![CDATA[KM]]></given-names>
</name>
<name>
<surname><![CDATA[Berger]]></surname>
<given-names><![CDATA[DH]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Use of a predictive equation for diagnosis of acute gangrenous cholecystitis]]></article-title>
<source><![CDATA[Am J Surg]]></source>
<year>2004</year>
<volume>188</volume>
<page-range>463-6</page-range></nlm-citation>
</ref>
<ref id="B6">
<label>6</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Aydin]]></surname>
<given-names><![CDATA[C]]></given-names>
</name>
<name>
<surname><![CDATA[Altaca]]></surname>
<given-names><![CDATA[G]]></given-names>
</name>
<name>
<surname><![CDATA[Berber]]></surname>
<given-names><![CDATA[I]]></given-names>
</name>
<name>
<surname><![CDATA[Tekin]]></surname>
<given-names><![CDATA[K]]></given-names>
</name>
<name>
<surname><![CDATA[Kara]]></surname>
<given-names><![CDATA[M]]></given-names>
</name>
<name>
<surname><![CDATA[Titiz]]></surname>
<given-names><![CDATA[I]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Prognostic parameters for the prediction of acute gangrenous cholecystitis]]></article-title>
<source><![CDATA[J Hepatobiliary Pancreat Surg]]></source>
<year>2006</year>
<volume>13</volume>
<page-range>155-9</page-range></nlm-citation>
</ref>
<ref id="B7">
<label>7</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Fry]]></surname>
<given-names><![CDATA[DE]]></given-names>
</name>
<name>
<surname><![CDATA[Cox]]></surname>
<given-names><![CDATA[RA]]></given-names>
</name>
<name>
<surname><![CDATA[Harbrecht]]></surname>
<given-names><![CDATA[PJ]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Gangrene of the gallbladder:a complication of acute cholecystitis]]></article-title>
<source><![CDATA[South Med J]]></source>
<year>1981</year>
<volume>74</volume>
<page-range>666-8</page-range></nlm-citation>
</ref>
<ref id="B8">
<label>8</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Ambe]]></surname>
<given-names><![CDATA[PC]]></given-names>
</name>
<name>
<surname><![CDATA[Papadakis]]></surname>
<given-names><![CDATA[M]]></given-names>
</name>
<name>
<surname><![CDATA[Zirngibl]]></surname>
<given-names><![CDATA[H]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[A proposal for a preoperative clinical scoring system for acute cholecystitis]]></article-title>
<source><![CDATA[J Surg Res]]></source>
<year>2016</year>
<volume>200</volume>
<page-range>473-9</page-range></nlm-citation>
</ref>
<ref id="B9">
<label>9</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Yeh]]></surname>
<given-names><![CDATA[DD]]></given-names>
</name>
<name>
<surname><![CDATA[Cropano]]></surname>
<given-names><![CDATA[C]]></given-names>
</name>
<name>
<surname><![CDATA[Fagenholz]]></surname>
<given-names><![CDATA[P]]></given-names>
</name>
<name>
<surname><![CDATA[King]]></surname>
<given-names><![CDATA[DR]]></given-names>
</name>
<name>
<surname><![CDATA[Chang]]></surname>
<given-names><![CDATA[Y]]></given-names>
</name>
<name>
<surname><![CDATA[Klein]]></surname>
<given-names><![CDATA[EN]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Gangrenous cholecystitis:deceiving ultrasounds, significant delay in surgical consult, and increased postoperative morbidity?]]></article-title>
<source><![CDATA[J Trauma Acute Care Surg]]></source>
<year>2015</year>
<volume>79</volume>
<page-range>812-6</page-range></nlm-citation>
</ref>
<ref id="B10">
<label>10</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Bennett]]></surname>
<given-names><![CDATA[GL]]></given-names>
</name>
<name>
<surname><![CDATA[Rusinek]]></surname>
<given-names><![CDATA[H]]></given-names>
</name>
<name>
<surname><![CDATA[Lisi]]></surname>
<given-names><![CDATA[V]]></given-names>
</name>
<name>
<surname><![CDATA[Israel]]></surname>
<given-names><![CDATA[GM]]></given-names>
</name>
<name>
<surname><![CDATA[Krinsky]]></surname>
<given-names><![CDATA[GA]]></given-names>
</name>
<name>
<surname><![CDATA[Slywotzky]]></surname>
<given-names><![CDATA[CM]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[CT findings in acute gangrenous cholecystitis]]></article-title>
<source><![CDATA[AJR Am J Roentgenol]]></source>
<year>2002</year>
<volume>178</volume>
<page-range>275-81</page-range></nlm-citation>
</ref>
<ref id="B11">
<label>11</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Lee]]></surname>
<given-names><![CDATA[SK]]></given-names>
</name>
<name>
<surname><![CDATA[Lee]]></surname>
<given-names><![CDATA[SC]]></given-names>
</name>
<name>
<surname><![CDATA[Park]]></surname>
<given-names><![CDATA[JW]]></given-names>
</name>
<name>
<surname><![CDATA[Kim]]></surname>
<given-names><![CDATA[S-J]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[The utility of the preoperative neutrophil-to-lymphocyte ratio in predicting severe cholecystitis:a retrospective cohort study]]></article-title>
<source><![CDATA[BMC Surg]]></source>
<year>2014</year>
<volume>14</volume>
<page-range>100</page-range></nlm-citation>
</ref>
<ref id="B12">
<label>12</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Beliaev]]></surname>
<given-names><![CDATA[AM]]></given-names>
</name>
<name>
<surname><![CDATA[Angelo]]></surname>
<given-names><![CDATA[N]]></given-names>
</name>
<name>
<surname><![CDATA[Booth]]></surname>
<given-names><![CDATA[M]]></given-names>
</name>
<name>
<surname><![CDATA[Bergin]]></surname>
<given-names><![CDATA[C]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Evaluation of neutrophil-to-lymphocyte ratio as a potential biomarker for acute cholecystitis]]></article-title>
<source><![CDATA[J Surg Res]]></source>
<year>2017</year>
<volume>209</volume>
<page-range>93-101</page-range></nlm-citation>
</ref>
<ref id="B13">
<label>13</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Yuzbasioglu]]></surname>
<given-names><![CDATA[Y]]></given-names>
</name>
<name>
<surname><![CDATA[Duymaz]]></surname>
<given-names><![CDATA[H]]></given-names>
</name>
<name>
<surname><![CDATA[Tanrikulu]]></surname>
<given-names><![CDATA[CS]]></given-names>
</name>
<name>
<surname><![CDATA[Halhalli]]></surname>
<given-names><![CDATA[HC]]></given-names>
</name>
<name>
<surname><![CDATA[Koc]]></surname>
<given-names><![CDATA[MO]]></given-names>
</name>
<name>
<surname><![CDATA[Tando&#287;an]]></surname>
<given-names><![CDATA[M]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Role of procalcitonin in evaluation of the severity of acute cholecystitis]]></article-title>
<source><![CDATA[Eurasian J Med]]></source>
<year>2016</year>
<volume>48</volume>
<page-range>162-6</page-range></nlm-citation>
</ref>
<ref id="B14">
<label>14</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Mok]]></surname>
<given-names><![CDATA[KWJ]]></given-names>
</name>
<name>
<surname><![CDATA[Reddy]]></surname>
<given-names><![CDATA[R]]></given-names>
</name>
<name>
<surname><![CDATA[Wood]]></surname>
<given-names><![CDATA[F]]></given-names>
</name>
<name>
<surname><![CDATA[Turner]]></surname>
<given-names><![CDATA[P]]></given-names>
</name>
<name>
<surname><![CDATA[Ward]]></surname>
<given-names><![CDATA[JB]]></given-names>
</name>
<name>
<surname><![CDATA[Pursnani]]></surname>
<given-names><![CDATA[KG]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Is C-reactive protein a useful adjunct in selecting patients for emergency cholecystectomy by predicting severe/gangrenous cholecystitis?]]></article-title>
<source><![CDATA[Int J Surg]]></source>
<year>2014</year>
<volume>12</volume>
<page-range>649-53</page-range></nlm-citation>
</ref>
<ref id="B15">
<label>15</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Beliaev]]></surname>
<given-names><![CDATA[AM]]></given-names>
</name>
<name>
<surname><![CDATA[Marshall]]></surname>
<given-names><![CDATA[RJ]]></given-names>
</name>
<name>
<surname><![CDATA[Booth]]></surname>
<given-names><![CDATA[M]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[C-reactive protein has a better discriminative power than white cell count in the diagnosis of acute cholecystitis]]></article-title>
<source><![CDATA[J Surg Res]]></source>
<year>2015</year>
<volume>198</volume>
<page-range>66-72</page-range></nlm-citation>
</ref>
<ref id="B16">
<label>16</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Yokoe]]></surname>
<given-names><![CDATA[M]]></given-names>
</name>
<name>
<surname><![CDATA[Hata]]></surname>
<given-names><![CDATA[J]]></given-names>
</name>
<name>
<surname><![CDATA[Takada]]></surname>
<given-names><![CDATA[T]]></given-names>
</name>
<name>
<surname><![CDATA[Strasberg]]></surname>
<given-names><![CDATA[SM]]></given-names>
</name>
<name>
<surname><![CDATA[Asburn]]></surname>
<given-names><![CDATA[HJ]]></given-names>
</name>
<name>
<surname><![CDATA[Wakabayashi]]></surname>
<given-names><![CDATA[G]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Tokyo Guidelines 2018. Diagnostic criteria and severity grading of acute cholecystitis (with videos)]]></article-title>
<source><![CDATA[J Hepatobiliary Pancreat Sci]]></source>
<year>2018</year>
<volume>25</volume>
<page-range>41-54</page-range></nlm-citation>
</ref>
<ref id="B17">
<label>17</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Merriam]]></surname>
<given-names><![CDATA[LT]]></given-names>
</name>
<name>
<surname><![CDATA[Kanaan]]></surname>
<given-names><![CDATA[SA]]></given-names>
</name>
<name>
<surname><![CDATA[Dawes]]></surname>
<given-names><![CDATA[LG]]></given-names>
</name>
<name>
<surname><![CDATA[Angelos]]></surname>
<given-names><![CDATA[P]]></given-names>
</name>
<name>
<surname><![CDATA[Prystowsky]]></surname>
<given-names><![CDATA[JB]]></given-names>
</name>
<name>
<surname><![CDATA[Rege]]></surname>
<given-names><![CDATA[RV]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Gangrenous cholecystitis:analysis of risk factors and experience with laparoscopic cholecystectomy]]></article-title>
<source><![CDATA[Surgery]]></source>
<year>1999</year>
<volume>126</volume>
<page-range>680-5</page-range></nlm-citation>
</ref>
<ref id="B18">
<label>18</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Ambe]]></surname>
<given-names><![CDATA[PC]]></given-names>
</name>
<name>
<surname><![CDATA[Christ]]></surname>
<given-names><![CDATA[H]]></given-names>
</name>
<name>
<surname><![CDATA[Wassenberg]]></surname>
<given-names><![CDATA[D]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Does the Tokyo guidelines predict the extent of gallbladder inflammation in patients with acute cholecystitis?A single center retrospective analysis]]></article-title>
<source><![CDATA[BMC Gastroenterol]]></source>
<year>2015</year>
<volume>15</volume>
<page-range>142</page-range></nlm-citation>
</ref>
<ref id="B19">
<label>19</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Bourikian]]></surname>
<given-names><![CDATA[S]]></given-names>
</name>
<name>
<surname><![CDATA[Anand]]></surname>
<given-names><![CDATA[RJ]]></given-names>
</name>
<name>
<surname><![CDATA[Aboutanos]]></surname>
<given-names><![CDATA[M]]></given-names>
</name>
<name>
<surname><![CDATA[Wolfe]]></surname>
<given-names><![CDATA[LG]]></given-names>
</name>
<name>
<surname><![CDATA[Ferrada]]></surname>
<given-names><![CDATA[P]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Risk factors for acute gangrenous cholecystitis in emergency general surgery patients]]></article-title>
<source><![CDATA[Am J Surg]]></source>
<year>2015</year>
<volume>210</volume>
<page-range>730-3</page-range></nlm-citation>
</ref>
<ref id="B20">
<label>20</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Stefanidis]]></surname>
<given-names><![CDATA[D]]></given-names>
</name>
<name>
<surname><![CDATA[Sirinek]]></surname>
<given-names><![CDATA[KR]]></given-names>
</name>
<name>
<surname><![CDATA[Bingener]]></surname>
<given-names><![CDATA[J]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Gallbladder perforation:risk factors and outcome]]></article-title>
<source><![CDATA[J Surg Res]]></source>
<year>2006</year>
<volume>131</volume>
<page-range>204-8</page-range></nlm-citation>
</ref>
<ref id="B21">
<label>21</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Nikfarjam]]></surname>
<given-names><![CDATA[M]]></given-names>
</name>
<name>
<surname><![CDATA[Harnaen]]></surname>
<given-names><![CDATA[E]]></given-names>
</name>
<name>
<surname><![CDATA[Tufail]]></surname>
<given-names><![CDATA[F]]></given-names>
</name>
<name>
<surname><![CDATA[Muralidharan]]></surname>
<given-names><![CDATA[V]]></given-names>
</name>
<name>
<surname><![CDATA[Fink]]></surname>
<given-names><![CDATA[MA]]></given-names>
</name>
<name>
<surname><![CDATA[Starkey]]></surname>
<given-names><![CDATA[G]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Sex differences and outcomes of management of acute cholecystitis]]></article-title>
<source><![CDATA[Surg Laparosc Endosc Percutan Tech]]></source>
<year>2013</year>
<volume>23</volume>
<page-range>61-5</page-range></nlm-citation>
</ref>
<ref id="B22">
<label>22</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Teefey]]></surname>
<given-names><![CDATA[SA]]></given-names>
</name>
<name>
<surname><![CDATA[Dahiya]]></surname>
<given-names><![CDATA[N]]></given-names>
</name>
<name>
<surname><![CDATA[Middleton]]></surname>
<given-names><![CDATA[WD]]></given-names>
</name>
<name>
<surname><![CDATA[Bajaj]]></surname>
<given-names><![CDATA[S]]></given-names>
</name>
<name>
<surname><![CDATA[Dahiya]]></surname>
<given-names><![CDATA[N]]></given-names>
</name>
<name>
<surname><![CDATA[Ylagan]]></surname>
<given-names><![CDATA[L]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Acute cholecystitis:do sonographic findings and WBC count predict gangrenous changes?]]></article-title>
<source><![CDATA[AJR Am J Roentgenol]]></source>
<year>2013</year>
<volume>200</volume>
<page-range>363-9</page-range></nlm-citation>
</ref>
<ref id="B23">
<label>23</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Lee]]></surname>
<given-names><![CDATA[SK]]></given-names>
</name>
<name>
<surname><![CDATA[Lee]]></surname>
<given-names><![CDATA[SC]]></given-names>
</name>
<name>
<surname><![CDATA[Park]]></surname>
<given-names><![CDATA[JW]]></given-names>
</name>
<name>
<surname><![CDATA[Kim]]></surname>
<given-names><![CDATA[SJ]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[The utility of the preoperative neutrophil-to-lymphocyte ratio in predicting severe cholecystitis:a retrospective cohort study]]></article-title>
<source><![CDATA[BMC Surg]]></source>
<year>2014</year>
<volume>14</volume>
<page-range>100</page-range></nlm-citation>
</ref>
<ref id="B24">
<label>24</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Beliaev]]></surname>
<given-names><![CDATA[AM]]></given-names>
</name>
<name>
<surname><![CDATA[Angelo]]></surname>
<given-names><![CDATA[N]]></given-names>
</name>
<name>
<surname><![CDATA[Booth]]></surname>
<given-names><![CDATA[M]]></given-names>
</name>
<name>
<surname><![CDATA[Bergin]]></surname>
<given-names><![CDATA[C]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Evaluation of neutrophil-to-lymphocyte ratio as a potential biomarker for acute cholecystitis]]></article-title>
<source><![CDATA[J Surg Res]]></source>
<year>2017</year>
<volume>209</volume>
<page-range>93-101</page-range></nlm-citation>
</ref>
<ref id="B25">
<label>25</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Nikfarjam]]></surname>
<given-names><![CDATA[M]]></given-names>
</name>
<name>
<surname><![CDATA[Niumsawatt]]></surname>
<given-names><![CDATA[V]]></given-names>
</name>
<name>
<surname><![CDATA[Sethu]]></surname>
<given-names><![CDATA[A]]></given-names>
</name>
<name>
<surname><![CDATA[Fink]]></surname>
<given-names><![CDATA[MA]]></given-names>
</name>
<name>
<surname><![CDATA[Muralidharan]]></surname>
<given-names><![CDATA[V]]></given-names>
</name>
<name>
<surname><![CDATA[Starkey]]></surname>
<given-names><![CDATA[G]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Outcomes of contemporary management of gangrenous and non-gangrenous acute cholecystitis]]></article-title>
<source><![CDATA[HPB (Oxford)]]></source>
<year>2011</year>
<volume>13</volume>
<page-range>551-8</page-range></nlm-citation>
</ref>
<ref id="B26">
<label>26</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Jessica Mok]]></surname>
<given-names><![CDATA[KW]]></given-names>
</name>
<name>
<surname><![CDATA[Goh]]></surname>
<given-names><![CDATA[YL]]></given-names>
</name>
<name>
<surname><![CDATA[Howell]]></surname>
<given-names><![CDATA[LE]]></given-names>
</name>
<name>
<surname><![CDATA[Date]]></surname>
<given-names><![CDATA[RS]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Is C-reactive protein the single most useful predictor of difficult laparoscopic cholecystectomy or its conversion?A pilot study]]></article-title>
<source><![CDATA[J Minim Access Surg]]></source>
<year>2016</year>
<volume>12</volume>
<page-range>26-32</page-range></nlm-citation>
</ref>
<ref id="B27">
<label>27</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Wevers]]></surname>
<given-names><![CDATA[KP]]></given-names>
</name>
<name>
<surname><![CDATA[van Westreenen]]></surname>
<given-names><![CDATA[HL]]></given-names>
</name>
<name>
<surname><![CDATA[Patijn]]></surname>
<given-names><![CDATA[GA]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Laparoscopic cholecystectomy in acute cholecystitis:C-reactive protein level combined with age predicts conversion]]></article-title>
<source><![CDATA[Surg Laparosc Endosc Percutan Tech]]></source>
<year>2013</year>
<volume>23</volume>
<page-range>163-6</page-range></nlm-citation>
</ref>
<ref id="B28">
<label>28</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Wu]]></surname>
<given-names><![CDATA[C]]></given-names>
</name>
<name>
<surname><![CDATA[Chen]]></surname>
<given-names><![CDATA[C]]></given-names>
</name>
<name>
<surname><![CDATA[Wang]]></surname>
<given-names><![CDATA[C]]></given-names>
</name>
<name>
<surname><![CDATA[Wong]]></surname>
<given-names><![CDATA[Y]]></given-names>
</name>
<name>
<surname><![CDATA[Wang]]></surname>
<given-names><![CDATA[L]]></given-names>
</name>
<name>
<surname><![CDATA[Huang]]></surname>
<given-names><![CDATA[C]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Discrimination of gangrenous from uncomplicated acute cholecystitis:accuracy of CT findings]]></article-title>
<source><![CDATA[Abdom Imaging]]></source>
<year>2011</year>
<volume>36</volume>
<page-range>174-8</page-range></nlm-citation>
</ref>
<ref id="B29">
<label>29</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Kalliafas]]></surname>
<given-names><![CDATA[S]]></given-names>
</name>
<name>
<surname><![CDATA[Ziegler]]></surname>
<given-names><![CDATA[DW]]></given-names>
</name>
<name>
<surname><![CDATA[Flancbaum]]></surname>
<given-names><![CDATA[L]]></given-names>
</name>
<name>
<surname><![CDATA[Choban]]></surname>
<given-names><![CDATA[PS]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Acute acalculous cholecystitis:incidence, risk factors, diagnosis, and outcome]]></article-title>
<source><![CDATA[Am Surg]]></source>
<year>1998</year>
<volume>64</volume>
<page-range>471-5</page-range></nlm-citation>
</ref>
<ref id="B30">
<label>30</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Yeh]]></surname>
<given-names><![CDATA[D]]></given-names>
</name>
<name>
<surname><![CDATA[Cropano]]></surname>
<given-names><![CDATA[C]]></given-names>
</name>
<name>
<surname><![CDATA[Fagenholz]]></surname>
<given-names><![CDATA[P]]></given-names>
</name>
<name>
<surname><![CDATA[King]]></surname>
<given-names><![CDATA[D]]></given-names>
</name>
<name>
<surname><![CDATA[Chang]]></surname>
<given-names><![CDATA[Y]]></given-names>
</name>
<name>
<surname><![CDATA[Klein]]></surname>
<given-names><![CDATA[E]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Gangrenous cholecystitis:deceiving ultrasounds, significant delay in surgical consult, and increased postoperative morbidity]]></article-title>
<source><![CDATA[J Trauma Acute Care Surg]]></source>
<year>2015</year>
<volume>79</volume>
<page-range>812-6</page-range></nlm-citation>
</ref>
<ref id="B31">
<label>31</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Csendes]]></surname>
<given-names><![CDATA[A]]></given-names>
</name>
<name>
<surname><![CDATA[Burdiles]]></surname>
<given-names><![CDATA[P]]></given-names>
</name>
<name>
<surname><![CDATA[Maluenda]]></surname>
<given-names><![CDATA[F]]></given-names>
</name>
<name>
<surname><![CDATA[Diaz]]></surname>
<given-names><![CDATA[JC]]></given-names>
</name>
<name>
<surname><![CDATA[Csendes]]></surname>
<given-names><![CDATA[P]]></given-names>
</name>
<name>
<surname><![CDATA[Mitru]]></surname>
<given-names><![CDATA[N]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Simultaneous bacteriologic assessment of bile from gallbladder and common bile duct in control subjects and patients with gallstones and common duct stones]]></article-title>
<source><![CDATA[Arch Surg]]></source>
<year>1996</year>
<volume>131</volume>
<page-range>389</page-range></nlm-citation>
</ref>
<ref id="B32">
<label>32</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Fitzgibbons Jr]]></surname>
<given-names><![CDATA[RJ]]></given-names>
</name>
<name>
<surname><![CDATA[Tseng]]></surname>
<given-names><![CDATA[A]]></given-names>
</name>
<name>
<surname><![CDATA[Wang]]></surname>
<given-names><![CDATA[H]]></given-names>
</name>
<name>
<surname><![CDATA[Ryberg]]></surname>
<given-names><![CDATA[A]]></given-names>
</name>
<name>
<surname><![CDATA[Nguyen]]></surname>
<given-names><![CDATA[N]]></given-names>
</name>
<name>
<surname><![CDATA[Sims]]></surname>
<given-names><![CDATA[KL]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Acute cholecystitis. Does the clinical diagnosis correlate with the pathological diagnosis?]]></article-title>
<source><![CDATA[Surg Endosc]]></source>
<year>1996</year>
<volume>10</volume>
<page-range>1180-4</page-range></nlm-citation>
</ref>
</ref-list>
</back>
</article>
