Severe acute calculous cholecystitis (grade III) is defined as being accompanied by dysfunctions in any one of the following organs or systems: cardiovascular dysfunction with hypotension requiring treatment, neurological dysfunction (decreased level of consciousness), respiratory dysfunction (PaO2/FIO2 ratio <300), renal dysfunction (oliguria, creatinine > 2.0 mg/dL liver dysfunction (prothrombin time > 3, international normalized ratio > 2) or platelet count <100 000/μL. This evidence concerns the gene F2 and Decreased liver function.