Document 0189
 DOCN  M94A0189
 TI    Cholecystectomy for cholecystitis in patients with acquired immune
       deficiency syndrome.
 DT    9412
 AU    Wind P; Chevallier JM; Jones D; Frileux P; Cugnenc PH; General and
       Digestive Surgical Service, Hopital Laennec, Paris,; France.
 SO    Am J Surg. 1994 Sep;168(3):244-6. Unique Identifier : AIDSLINE
       MED/94361228
 AB    Acalculous cholecystitis, a recognized manifestation of acquired immune
       deficiency syndrome (AIDS), causes abdominal pain which can be relieved
       by cholecystectomy. The indications for cholecystectomy have remained
       undefined, however, because the cholecystitis is usually accompanied by
       generalized cholangitis and it is difficult to distinguish the relative
       clinical importance of the two problems. Since 1985, we have performed
       cholecystectomy on 8 patients with AIDS who had clinical manifestations
       of acute cholecystitis associated with a thickening of the gallbladder
       wall by 5 mm to 12 mm. Two of the 8 had gallstones and 4 had associated
       cholangitis. All had been treated with antibiotics for 20 to 180 days
       before surgery, but physical deterioration had progressed in every case.
       At the moment of surgical intervention, 4 patients had multiple organ
       failure. One patient died 3 days postoperatively, but the rest recovered
       rapidly with resolution of the abdominal pain and sepsis. Two patients
       died 20 days after surgery due to complications of AIDS. The remaining 5
       died due to AIDS at 6, 9, 10, 12, and 14 months after surgery. Two of
       this group developed progressive cholangitis with raised serum alkaline
       phosphatase. Our experience indicates that cholecystectomy should be
       considered for the treatment of severe and persistent symptoms of
       hepatobiliary manifestations of AIDS notwithstanding the presence of
       cholangitis.
 DE    Adult  AIDS-Related Opportunistic Infections/*SURGERY
       Cholangitis/COMPLICATIONS  *Cholecystectomy
       Cholecystitis/COMPLICATIONS/*SURGERY  Female  Human  Male  Middle Age
       Treatment Outcome  JOURNAL ARTICLE

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