Gangrenous cholecystitis is a serious disorder with increased morbidity and mortality. A delay in surgery can increase the risk to the patient.
Reasons for delay in time to surgery:
(1) delay in patient coming in for medical care
(2) delay in asking for a surgical consult
(3) delay in surgeon evaluating the patient
(4) delay between consult and surgery
Reasons for delay:
(1) failure to recognize a high-risk patient
(2) unimpressive clinical findings
(3) normal or near normal ultrasound
(4) normal or borderline increase in laboratory values (white blood cell count, serum total bilirubin, liver function tests)
(5) failure to adequately monitor the patient
(6) failure to perform additional imaging studies
