Surgery Improves Long-Term Survival in Kidney Failure Patients with Acute Cholecystitis: Study

Key Findings

• Of 46,779 patients receiving chronic KRT, 1,520 presented initially with acute cholecystitis in emergency.

• Nonoperative management was provided to 87% of patients, while the rest were subjected to cholecystectomy.

• 30-day mortality rates between the surgery and nonoperative groups were comparable (5.4% vs. 5.1%, p =0.83).

Surgery was linked to higher risks of nonfatal complications, such as:

• Cardiovascular complications (OR 2.08, 95% CI 1.13–3.81)

• ICU admission (OR 3.51, 95% CI 2.41–5.10)

• Blood transfusions (OR 2.29, 95% CI 1.60–3.27)

• 12-month survival was increased significantly in the surgery group (HR 0.61, 95% CI 0.43–0.87) compared to nonoperatively treated patients.

• Increased 30-day readmission was observed in the nonoperative group (17.6% vs. 12.5%, p = 0.44).

The study authors concluded that patients with kidney failure undergoing chronic KRT who undergo an operation for acute cholecystitis have better 12-month survival rates when compared to nonoperative management patients. These observations point toward the necessity of individualized treatment protocols and vigilant monitoring to maximize patient benefit.

Reference:

Palamuthusingam, D., Hawley, C. M., Pascoe, E. M., Johnson, D. W., Sivalingam, P., Wood, S. T., Palamuthusingam, P., Jose, M. D., & Fahim, M. (2025). Operative and nonoperative management of acute cholecystitis in patients on chronic kidney replacement therapy. Journal of Hepato-Biliary-Pancreatic Sciences. https://doi.org/10.1002/jhbp.12133