THE SIGNIFICANCE OF C-REACTIVE PROTEIN IN PREDICTING THE COMPLEXITY OF LAPAROSCOPIC CHOLECYSTECTOMY OR THE NEED FOR ITS CONVERSIONS
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Keywords
C-reactive protein, Difficult Laparoscopic Cholecystectomy, Laparoscopic Cholecystectomy
Abstract
Introduction:
Gallstone disease is a common gastrointestinal pathology, and laparoscopic cholecystectomy (LC) is the preferred approach. However, predicting cases requiring conversion to open cholecystectomy is crucial for optimal surgical planning. C-reactive protein (CRP) has emerged as a potential preoperative marker, reflecting systemic inflammation.
Objective:
This study aims to evaluate the role of CRP in predicting difficult laparoscopic cholecystectomy and the need for conversion to open surgery. We investigate the association between preoperative CRP levels and intraoperative challenges, contributing to risk stratification.
Materials and Methods:
Seventy-four cholelithiasis patients underwent preoperative CRP assessment. A scoring system categorized patients into simple, difficult, or conversion cases. Intraoperative parameters, including operating time, adhesions, bile spillage, injuries, and Nasser grading, were recorded. Statistical analyses determined correlations and scoring system reliability.
Results:
Patients (n=74) had a mean age of 47.19 years, with a female predominance (female-to-male ratio 1.28:1). Abdominal pain (97.3%) and vomiting (74.3%) were prevalent symptoms. CRP levels correlated significantly with surgical complexity (p=0.0003). Longer durations were associated with difficult cases (p=0.0001). Postoperative stay increased with complexity (p=0.0001). CRP >22 mg/dl showed a significant association with difficult cases (p=0.003), while CRP >46 mg/dl correlated with conversion (p=0.026).
Discussion:
Our findings align with literature associating CRP with surgical outcomes. Higher CRP levels correlated with challenging surgeries, supporting its role as a predictor. The study's strength lies in detailed intraoperative assessments, validating CRP's utility in anticipating difficulties.
Conclusion:
CRP proves valuable in predicting laparoscopic cholecystectomy challenges, aiding risk stratification. Surgeons can consider this information for informed decision-making, optimizing patient care and outcomes
References
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This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.
All articles published in JPTCP are licensed under Copyright Creative Commons Attribution-NonCommercial 4.0 International License.
Ratcha Sandesh
Surgery resident, Department of General Surgery, SVMCH&RC, Pondicherry
Gowthaman. M. D
Assistant professor, Department of General Surgery, SVMCH&RC, Pondicherry
Selvakumar K
Professor and Head of the Department, Department of General Surgery, SVMCH&RC, Pondicherry
Indrajit Anandakannan
Assistant professor, Department of General Surgery, Sri venkateshwaraa medical college hospital and research centre (SVMCH& RC), Pondicherry.Phone (or Mobile) No.: +91-9486752808
Lochan Thanigachalam
Assistant professor, Department of General Surgery, SVMCH&RC, Pondicherry