THE PREDICTIVE VALUE OF C-REACTIVE PROTEIN (CRP) AS A MARKER FOR DIFFICULT LAPAROSCOPIC CHOLECYSTECTOMY OR ITS CONVERSION

Main Article Content

Zubair Ahmed Yousfani
Jabeen Atta
Khenpal Das
Muhammad Hanzala Yousfani
Ghulamullah Rind
Maria Memon

Keywords

C-reactive protein, laparoscopic cholecystectomy, open surgery

Abstract

Background: For the majority of patients with gallbladder problems, laparoscopic cholecystectomy (LC) is the recommended operation since it is associated with less pain and a quicker return to regular activities than open cholecystectomy. Laparoscopic cholecystectomy can be easy or difficult, and conversion to open surgery is frequently seen as an indication of a difficult treatment (2–7%). The exact ratio of when to choose an open treatment versus how long a surgeon should continue with a laparoscopic procedure is not well defined. When a laparoscopic cholecystectomy is performed for more than two hours, perioperative problems are four times more likely to occur than during 30- to 60-minute procedures.


Objective: To evaluate the predictive value of CRP in identifying laparoscopic cholecystectomy complications or the necessity of switching to an open operation.


Study design: A cross-sectional study


Place and Duration: This study was conducted at XXX Hospital from June 2022 to June 2023.


Methodology: This study encompassed all individuals with cholelithiasis who were admitted to a specific hospital unit and underwent laparoscopic cholecystectomy. For all the participants, CRP was done. Patients with a proven congenital anomaly of gallbladder, any other situation increasing CRP, a high BMI (>35), or previous abdominal surgery were not included in this research. Moreover, immunocompromised patients were also excluded. SPSS version 26 was used for statistical analysis.


Results: There were a total of 180 people involved in this research. The mean age of the patients was 50.41 years. There were a total of 146 females and 34 males. The most common complaint was pain in the abdomen, which was present in 97.2% of participants. A total of 132 patients had simple cholecystectomy, 39 had difficult cholecystectomy, and 9 converted to open cholecystectomy. The level of CRP increased with the increase in difficulty of dissection.


Conclusion: According to the current research, preoperative CRP levels are a reliable indicator of potential difficulties during laparoscopic cholecystectomy as well as the possibility of an open surgery being necessary.

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