Admission CRP Level as an Indicator for the Need of Percutaneous Cholecystostomy in Acute Cholecystitis

Nizri, Eran; Epstein, Lilach

doi:10.4172/2161-069x.1000413

Cited by 2 publications

(2 citation statements)

References 20 publications

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“…CRP is an acute-phase reactant produced by hepatocytes and may be elevated in many infectious, autoimmune, and cancerous diseases, including acute cholecystitis. [12] There are some studies in the literature that support our study and suggest that CRP may be an important predictive marker for CAC. Mahmood et al showed that a CRP value > 55 mg/L is an important marker for CAC.…”

Section: Discussionsupporting

confidence: 83%

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A novel approach to distinguish complicated and non-complicated acute cholecystitis: Decision tree method

et al. 2023

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It is difficult to differentiate between non-complicated acute cholecystitis (NCAC) and complicated acute cholecystitis (CAC) preoperatively, which are two separate pathologies with different management. The aim of this study was to create an algorithm that distinguishes between CAC and NCAC using the decision tree method, which includes simple examinations. In this retrospective study, the patients were divided into 2 groups: CAC (149 patients) and NCAC (885 patients). Parameters such as patient demographic data, American Society of Anesthesiologists (ASA) score, Tokyo grade, comorbidity findings, white blood cell (WBC) count, neutrophil/lymphocyte ratio, C-reactive protein (CRP) level, albumin level, CRP/albumin ratio (CAR), and gallbladder wall thickness (GBWT) were evaluated. In this algorithm, the CRP value became a very important parameter in the distinction between NCAC and CAC. Age was an important predictive factor in patients with CRP levels >57 mg/L, and the critical value for age was 42. After the age factor, the important parameters in the decision tree were WBC and GBWT. In patients with a CRP value of ≤57 mg/L, GBWT is decisive and the critical value is 4.85 mm. Age, neutrophil/lymphocyte ratio, and WBC count were among the other important factors after GBWT. Sex, ASA score, Tokyo grade, comorbidity, CAR, and albumin value did not have an effect on the distinction between NCAC and CAC. In statistical analysis, significant differences were found groups in terms of gender (34.8% vs 51.7% male), ASA score ( P < .001), Tokyo grade ( P < .001), comorbidity ( P < .001), albumin (4 vs 3.4 g/dL), and CAR (2.4 vs 38.4). By means of this algorithm, which includes low-cost examinations, NCAC and CAC distinction can be made easily and quickly within limited possibilities. Preoperative prediction of pathologies that are difficult to manage, such as CAC, can minimize patient morbidity and mortality.

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Section: Discussionsupporting

confidence: 83%

“…Studies comprising scoring systems or predictive factors have been conducted to differentiate between CAC. [ 6 , 11 , 12 ] However, no studies in the literature have created an algorithm using the decision tree method. In this respect, our algorithm is the first in the literature.…”

Section: Discussionmentioning

confidence: 99%

A novel approach to distinguish complicated and non-complicated acute cholecystitis: Decision tree method

et al. 2023

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C-reactive protein in gallbladder diseases: diagnostic and therapeutic insights

et al. 2020

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The gallbladder is an important component of the hepatobiliary system whose primary function is to aid in digestion of foodstuffs, excretion of drugs and facilitate removal of waste products from the body. The gall bladder is principally a storage organ for bile, chemically modified salts and acids of cholesterol which are synthesized in the liver and which function as surfactants to solubilize fatty substances of limited aqueous solubility. Any disruption in the amount or activity of bile surfactant can lead to an accumulation of insoluble molecular clumps (e.g., gallstones) that deposit in and obstruct fluid movement within the gallbladder, and which can lead to pathological congestion and tissue damage. The natural host defense response to any event that causes tissue damage is to stimulate inflammation, which non-specifically but aggressively reacts to the stimuli so to remove the cause and repair damaged tissues. The C-reactive protein (CRP) is a primarily hepatically produced serum protein whose blood levels increase within 6-10 h of any tissue-damaging event. The extent with which it increases correlates with the level of tissue damage and associated inflammation. CRP levels are reported to be of value in diagnosing acute cholecystitis severity, in predicting the outcome and prognosis of cancerassociated gallbladder resection, and in helping identify cystic structures during emergency laparoscopic cholecystectomies. As an understanding of distinctive CRP structural isoforms is evolving, its role not only as a biomarker but as regulator of both physiologic and pathophysiologic processes of inflammation may be relevant in the understanding of and treatment approaches for gallbladderassociated disease.

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Admission CRP Level as an Indicator for the Need of Percutaneous Cholecystostomy in Acute Cholecystitis

Abstract: Background: Percutaneous cholecystostomy (PC) and conservative treatment are alternatives to surgery in patients with moderate acute calculous cholecystitis. Failure or non-improvement after conservative treatment is an indication for PC.

Cited by 2 publications

References 20 publications

A novel approach to distinguish complicated and non-complicated acute cholecystitis: Decision tree method

A novel approach to distinguish complicated and non-complicated acute cholecystitis: Decision tree method

C-reactive protein in gallbladder diseases: diagnostic and therapeutic insights

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