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Órgano oficial de la Universidad Autónoma de Sinaloa

2024, Number 1

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Rev Med UAS 2024; 14 (1)

Prediction of difficult cholecystectomy in acute cholecystitis with C-reactive protein

Bolívar-Rodríguez MA, Mendoza-Chang CR, Cázarez-Aguilar MA, Pámanes-Lozano A, López-Manjarrez G

Language: Spanish
References: 27
Page: 13-22
PDF size: 407.21 Kb.


ABSTRACT

Objective: To evaluate C-reactive protein as a predictor of difficult cholecystectomy in acute cholecystitis, to determine the risk factors for difficult cholecystectomy and the percentage of conversion from laparoscopic cholecystectomy to open surgery in a second-level hospital. Material and methods: Observational, cross-sectional, and retrospective study of 100 consecutive cases with a diagnosis of acute cholecystitis and preoperative C-reactive protein, who underwent laparoscopic cholecystectomy in the period of March 2019 and October 2021 in a second-level hospital. Results: Of the 100 cases, difficult cholecystectomy was detected in a total of 39 (39%) patients, of which 5% converted to open surgery. The ROC curve determined the area under the curve value for CRP of 0.526 with a significant value of 0.666 and the best cut-off point of 3.5 mg/dl was established. Sensitivity of 59.0% (43.3-72.9, 95% CI), specificity of 49.2% (37.1-61.4, 95% CI), positive predictive value of 42.6% (30.3-55.8, 95% CI), negative predictive value of 65.2% (50.8-77.3, 95% CI), proportion of false positives of 50.8% (38.6-62.9, 95% CI), and proportion of false negatives of 41.0 (27.1-56.6, 95% CI), with accuracy of 53% (43.3-62.5, 95% CI). Conclusions: C-reactive protein individually and at a cut-off point of 3.5 mg/dL does not represent an optimal predictive marker for difficult cholecystectomy in patients with acute cholecystitis.


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