C-reactive protein has a better discriminative power than white cell count in the diagnosis of acute cholecystitis

Beliaev, Andrei M.; Marshall, Roger; Booth, Michael

doi:10.1016/j.jss.2015.05.005

Cited by 38 publications

(33 citation statements)

References 29 publications

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“…One study that addressed the association between CRP and the TG13 severity grading criteria found that a CRP level >7.065 mg/dl may be considered as Grade II with 75% sensitivity and 96.5% specificity [26]. Another study investigating the association between WBC count, CRP, and histopathological findings found that CRP has a better discriminative power than WBC count in most forms of AC and is a useful diagnostic marker of AC [27]. The fact that in our epidemiological results, the mean CRP level was 10.5 mg/dl indicates that the distribution of our patients is centered on Grade II.…”

Section: Discussionmentioning

confidence: 99%

Descriptive review of acute cholecystitis: Japan‐Taiwan collaborative epidemiological study

Yokoe

Takada

Hwang

et al. 2017

J Hepato Biliary Pancreat

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Background Since the publication of the Tokyo Guidelines (TG13) for the management of acute cholecystitis (AC), multidirectional studies have been published. However, epidemiological research about AC with big data was not projected. The aim of this study was to reveal the actual clinical conditions of AC. Method The study was designed as an international multicenter retrospective study of AC in Japan and Taiwan from 2011 to 2013. The factors investigated comprised data related to demographic, history, physical examinations, laboratory and imaging findings. Based on these data, we investigated the various values of AC, and real situation with respect to severity and treatment. Results A total of 5,459 patients with AC were reviewed. Thirty-day mortality rate was 1.1%. Based on the diagnostic criteria, 4,088 patients had a definite diagnosis and 291 had a suspected diagnosis. According to the severity grading, 939 patients were classified as Grade III, 2,308 as Grade II, and 2,130 as Grade I. Cholecystectomy was performed in total of 4,266 patients and 2,765 patients had laparoscopic cholecystectomy. The main etiologies were gallbladder stones in 4,623 cases. Conclusion This epidemiological study with large population will undoubtedly contribute to establish the best practice for managing AC worldwide.

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Section: Discussionmentioning

confidence: 99%

Descriptive review of acute cholecystitis: Japan‐Taiwan collaborative epidemiological study

Yokoe

Takada

Hwang

et al. 2017

J Hepato Biliary Pancreat

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“…It can be used to support the diagnosis of AC [1,[14][15][16]. Beliaev et al [14] showed that CRP level has better discriminative power than WBC count in most forms of AC and is a useful diagnostic marker of AC. CRP level increased in direct proportion with the severity of AC.…”

Section: Discussionmentioning

confidence: 99%

“…However, ESR is a marker with low sensitivity and specificity, which increases in several clinical conditions such as infections, autoimmune events, neoplasia, and pregnancy [14,17].…”

Section: Discussionmentioning

confidence: 99%

Role of Procalcitonin in Evaluation of the Severity of Acute Cholecystitis

Yüzbaşıoğlu¹,

Duymaz²,

Tanrıkulu³

et al. 2017

Eurasian J Med

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Objective: The aim of this study is to investigate the relationship between procalcitonin (PCT) level and the severity of acute cholecystitis. Materials and Methods:This study included 200 patients diagnosed with acute cholecystitis. To diagnose and assess the severity of acute cholecystitis; physical examination and abdominal ultrasound findings were evaluated and blood samples were taken to determine white blood cell (WBC) count, erythrocyte sedimentation rate (ESR), and levels of coagulation factors, blood gas, C-reactive protein (CRP) and PCT. Patients were classified into three stages, namely, mild, moderate, and severe, according to the severity of acute cholecystitis using the Tokyo guidelines. The role of PCT level in the assessment of severity of acute cholecystitis and the correlation between the stages and PCT level were statistically analyzed.Results: Among patients with acute cholecystitis, 110 (55%) were classified as mild, 61 (30.5%) as moderate, and 29 (14.5%) as severe. Leukocytosis or leukopenia was positive in 48.5%, ESR elevation was found in 72.5%, CRP positivity in 55.5%, PCT elevation in 27%, and positive findings of ultrasonographic imaging in 54.5% of the patients. Serum WBC count, ESR, and CRP and PCT levels increased as the severity of disease increased (p<0.05). PCT could discriminate grade I from grade II-III with 95.45% sensitivity and 46.67% specificity at the best cut-off value of ≤0.52 (p<0.001). PCT could also discriminate grade III from grade I-II with 72.4% sensitivity and 90.06% specificity at the best cut-off value of >0.8 (p<0.001).Conclusion: PCT level may be considered to be a parameter that could be added to the assessment of the severity of acute cholecystitis in the Tokyo guidelines, although further studies are needed to support our findings.Keywords: Procalcitonin, acute cholecystitis, severity of illness index ÖZ Amaç: Bu çalışmanın amacı akut kolesistitin şiddeti ile prokalsitonin (PCT) seviyesi arasındaki ilişkiyi araştırmaktır.Gereç ve Yöntem: Bu çalışmaya akut kolesistit tanısı alan 200 hasta alındı. Tanıyı koymak ve akut kolesistitin şiddetini belirlemek için; fizik muayene ve abdominal ulltrasonografi bulguları değerlendirildi ve beyaz küre sayımı (BKS), eritrosit sedimentasyon hızı (ESH), koagülasyon faktörleri, kan gazı, C-reaktif protein (CRP) ve PCT düzeylerini belirlemek için kan örnekleri alındı. Hastalar akut kolesistitin şiddetine göre Tokyo klavuzu kullanılarak hafif, orta ve ağır olmak üzere üç evrede sınıflandırıldı. Akut kolesistitin şiddetini değerlendirmede PCT düzeylerinin yeri ve PCT düzeyi ile evreler arasındaki korelasyon istatiksel olarak analiz edildi.Bulgular: Akut kolesistitli hastaların; 110 (%55)'u hafif, 61 (%30,5)'i orta ve 29 (14,5)'u ağır olarak sınıflan-dırıldı. Hastaların %48,5'inde lökositoz veya lökopeni, %72,5'inde ESH yüksekliği, %55,5'inde CRP pozitifliği, %27' sinde PCT yüksekliği ve %54,5'inde pozitif ultrasonografi bulguları saptandı. Serum BKS, ESH, CRP ve PCT düzeyleri hastalığın şiddetiyle beraber artış gösterdi...

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“…Table 4. Cut-off values and areas under receiver operating characteristic curve of CRP and WCC in acute cholecystitis (adapted from Beliaev et al [63]). …”

Section: Risk Factors and Predictivementioning

confidence: 99%

Risk Factors and Predictive Models for Conversion of Laparoscopic Cholecystectomy to Open Surgery, and Surgical Quality Outcome Measures

Beliaev¹,

Booth²

2016

Actual Problems of Emergency Abdominal Surgery

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Background: Laparoscopic cholecystectomy is the preferred surgical operation for symptomatic gallstone disease. Conversion of laparoscopic cholecystectomy to open surgery is used to prevent intra-abdominal organ injury, for open common bile duct exploration and to repair intra-abdominal organ injury. Objective:The objective of this chapter is to review risk factors and predictive models for conversion of laparoscopic cholecystectomy to open surgery, and surgical quality outcome measures. Methods:A narrative literature review using Pubmed, Medline, Cochrane library databases and Google search engine is described.Results: From the literature review, patient-and surgeon-related risk factors and predictive models for conversion of laparoscopic cholecystectomy to open surgery were identified. Patient-dependent risk factors included preoperative and intraoperative variables. Current conversion of laparoscopic cholecystectomy to open surgery predictive models use only patient-dependent risk factors and were not tested on an independent sample of patients. Surgical quality outcome measures incorporate an association between conversion and intra-abdominal organ injury that demonstrates that conversion was used as an emergency strategy to repair injuries rather than a safety measure. Conclusion:Conversion of laparoscopic cholecystectomy to open surgery risk stratification based on patient-and surgeon-dependent variables may allow a better management of the patient to keep conversion at low rates and to maintain benefits of minimally invasive surgery.

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C-reactive protein has a better discriminative power than white cell count in the diagnosis of acute cholecystitis

Cited by 38 publications

References 29 publications

Descriptive review of acute cholecystitis: Japan‐Taiwan collaborative epidemiological study

Descriptive review of acute cholecystitis: Japan‐Taiwan collaborative epidemiological study

Role of Procalcitonin in Evaluation of the Severity of Acute Cholecystitis

Risk Factors and Predictive Models for Conversion of Laparoscopic Cholecystectomy to Open Surgery, and Surgical Quality Outcome Measures

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