RT Journal Article SR Electronic T1 Use of non-operative treatment and interval cholecystectomy for cholecystitis in patients with cancer JF Trauma Surgery & Acute Care Open JO Trauma Surg Acute Care Open FD BMJ Publishing Group Ltd SP e000439 DO 10.1136/tsaco-2020-000439 VO 5 IS 1 A1 Santos, David A1 Ledet, Celia Robinson A1 Limmer, Angela A1 Gibson, Heather A1 Badgwell, Brian YR 2020 UL http://tsaco.bmj.com/content/5/1/e000439.abstract AB Background 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).Materials and methods We performed a case–control 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.Results 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% CI 1.36 to 32.6, p=0.09), abdominal radiation (OR=0.09, 95% CI 0.02 to 0.53, p<0.01), and PCT with resolution of AC (OR=4.89, 95% CI 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% CI 1.00 to 1.30, p=0.05).Conclusion 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.Level of evidence II.