C-reactive Protein-to-Albumin Ratio Predicts Conversion from Laparoscopic to Open Cholecystectomy in Acute Cholecystitis

Overview

Journal In Vivo

Specialty Oncology

Date 2023 Mar 7

PMID 36881091

Authors

Masashi Utsumi

Masaru Inagaki

Koji Kitada

Naoyuki Tokunaga

Kosuke Yunoki

Yuya Sakurai

Ryosuke Hamano

Yousuke Tsunemitsu

Hideaki Miyasou

Shinya Otsuka

Affiliations

Soon will be listed here.

Abstract

Background/aim: The aim of this study was to identify predictors of conversion from laparoscopic to open cholecystectomy, and to determine whether pre-operative C-reactive protein-to-albumin ratio (CAR) can predict conversion from laparoscopic to open cholecystectomy, in patients with acute cholecystitis diagnosed according to the Tokyo Guidelines 2018.

Patients And Methods: We retrospectively analysed 231 patients who underwent laparoscopic cholecystectomy for acute cholecystitis between January 2012 and March 2022. Two hundred and fifteen (93.1%) patients were included in the laparoscopic cholecystectomy group; sixteen (6.9%) patients were included in the conversion from laparoscopic to open cholecystectomy group.

Results: In univariate analysis, significant predictors of conversion from laparoscopic to open cholecystectomy included the interval between symptom onset and surgery (>72 h), C-reactive protein (≥15.0 mg/l) and albumin (<3.5 mg/l) levels, pre-operative CAR (≥5.54), gallbladder wall thickness (≥5 mm), pericholecystic fluid collection, and pericholecystic fat hyperdensity. In multivariate analysis, elevated pre-operative CAR (≥5.54) and the interval between symptom onset and surgery (>72 h) were independent predictors of conversion from laparoscopic to open cholecystectomy.

Conclusion: Pre-operative CAR as a predictor of conversion from laparoscopic to open cholecystectomy may be useful for pre-operative risk assessment and treatment planning.

Citing Articles

Does previous gastrectomy history affect the surgical outcomes of laparoscopic cholecystectomy?.

Shu X, Wen Z, Li Q BMC Surg. 2023; 23(1):318.

PMID: 37872530 PMC: 10594716. DOI: 10.1186/s12893-023-02237-7.

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