Performance and external validation of prediction models for gangrenous cholecystitis in emergency surgical patients: a systematic review

Background

Gangrenous cholecystitis complicates emergency surgical assessment because routine clinical findings overlap with nongangrenous inflammation. Preoperative prediction offers a basis for risk stratificati n and operative planning. This review evaluated model performance and the strength of external validation.

Methods

Two authors searched PubMed, Scopus, Web of Science, and the Cochrane Library through Jan 2026, screened studies, and extracted data. Original multivariable development and validation studies using operative or pathological gangrene outcomes were synthesized narratively. Discrimination, threshold accuracy, calibration, and validation design were examined separately.

Results