The role of C-reactive protein as a predictor of difficult laparoscopic cholecystectomy or its conversion

Bhanu Kaushik; Shalu Gupta; Somendra Bansal; Bhanwar Lal Yadav; Dinesh Bharti; Deepesh Kalra; Vikram Singh Sodha

doi:10.18203/2349-2902.isj20182239

Authors

Bhanu Kaushik Department of Surgery, SMS Medical College and Attached Hospitals, Jaipur, Rajasthan, India
Shalu Gupta Department of Surgery, SMS Medical College and Attached Hospitals, Jaipur, Rajasthan, India
Somendra Bansal Department of Surgery, SMS Medical College and Attached Hospitals, Jaipur, Rajasthan, India
Bhanwar Lal Yadav Department of Surgery, SMS Medical College and Attached Hospitals, Jaipur, Rajasthan, India
Dinesh Bharti Department of Surgery, SMS Medical College and Attached Hospitals, Jaipur, Rajasthan, India
Deepesh Kalra Department of Surgery, SMS Medical College and Attached Hospitals, Jaipur, Rajasthan, India
Vikram Singh Sodha Department of Surgery, SMS Medical College and Attached Hospitals, Jaipur, Rajasthan, India

DOI:

https://doi.org/10.18203/2349-2902.isj20182239

Keywords:

C-reactive protein, Difficult laparoscopic cholecystectomy, Laparoscopic cholecystectomy

Abstract

Background: Laparoscopic cholecystectomy (LC) can be the easiest or the most difficult laparoscopic operation. Conversion to open surgery has been a traditional marker of difficult LC. Recent studies have shown that C-reactive protein (CRP) may be helpful to surgeon in knowing the pathological condition of gall bladder before removal. Aim of this study was to evaluate the role of CRP as a predictor of difficult LC or its conversion.

Methods: This study was done from 1 march 2016 to may 2017 in department of general surgery, SMS hospital Jaipur, under single unit. All patients with cholelithiasis admitted in single unit of SMS hospital undergoing LC were included in this study. Exclusion criteria were high BMI (>35), proven congenital anomaly of gall bladder, previous abdominal surgery, any conditions increasing CRP and immunocompromised patients. CRP was done for each patient.

Results: Mean age of our 148 patients was 50.41 years. Female to male ratio was 4.28:1. Mean CRP was 22.2±18.2 mg/dl for simple cholecystectomy, 46.5±32.0 mg/dl for difficult cholecystectomy and 83.6±22.4 mg/dl for laparoscopic converted to open cholecystectomy, which was statistically significant (p value 0.0002).

Conclusions: CRP is a potent predictor of difficult laparoscopic cholecystectomy and its conversion preoperatively. Patients with preoperatively high CRP have higher chance of complication intraoperative and high chances of conversion to open.

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