An investigation into the predictive role of serum inflammatory parameters in the diagnosis of complicated acute cholecystitis

BACKGROUND: Gallbladder gangrene and perforation are an important complication of acute calculous cholecystitis and are dif-ficult to detect preoperatively. Therefore, in this study, we aimed to evaluate whether serum inflammatory parameters are predictive factors for complicated cholecystitis (CC).
METHODS: In the present study, histopathological findings of 250 patients who were operated on with the diagnosis of acute chole-cystitis (AC) in the emergency department between 2014 and 2019 were evaluated and the cases were divided into two groups as AC and CC. Parameters, including age, gender, body mass index, white blood cell (WBC) count, C-reactive protein (CRP), neutrophil-to-lym-phocyte ratio (NLR), mean platelet volume (MPV), and platelet distribution width (PDW), were examined for their ability to predict CC.
RESULTS: The findings obtained in this study showed that WBC, CRP, and NLR were significantly higher in the CC group (p<0.05). WBC >9.000 cells/ml, CRP >29.0, and NLR >4.3 were the factors that could predict CC. There was no significant difference between the two groups concerning MPV and PDW (p>0.05). CC was observed more frequently in patients over 65 years of age, but there was not a statistically significant difference (p=0468).
CONCLUSION: WBC, CRP, and NLR are valuable biochemical markers in predicting complicated AC. Advanced age may be a help-ful predictive factor for CC. These factors may be helpful in making an early cholecystectomy decision.

Komplike akut kolesistit tanýsýnda serum enflamatuvar parametrelerin öngörücü rolüne yönelik bir araþtýrma

AMAÇ: Safra kesesi gangreni ve perforasyonu, akut taþlý kolesistitin önemli bir komplikasyonudur ve ameliyat öncesi olarak tespit edilmesi zordur. Bu nedenle bu çalýþmada, serum enflamatuvar parametrelerin komplike kolesistit için prediktif faktör olup olmadýðýný deðerlendirmeyi amaçladýk. GEREÇ VE YÖNTEM: Bu çalýþmada acil serviste 2014–2019 yýllarý arasýnda akut kolesistit tanýsýyla ameliyat edilen 250 hastanýn histopatolojik bulgularý deðerlendirildi ve olgular akut kolesistit ve komplike kolesistit olarak iki gruba ayrýldý. Yaþ, cinsiyet, vücut kitle indeksi, beyaz kan hücresi sayýsý (WBC), C-reaktif protein (CRP), nötrofil-lenfosit oraný (NLR), ortalama trombosit hacmi (MPV) ve trombosit daðýlým geniþliði (PDW) gibi parametreler, komplike kolesistiti tahmin etme oranlarý açýsýndan incelendi.
BULGULAR: Bu çalýþmada elde edilen bulgular komplike kolesistit grubunda WBC, CRP ve NLR’nin anlamlý olarak daha yüksek olduðunu gösterdi (p<0.05). WBC >9.000 hücre/ml, CRP >29.0 ve NLR >4.3, komplike kolesistiti öngörebilen faktörlerdi. MPV ve PDW açýsýndan iki grup arasýnda anlamlý fark yoktu (p>0.05). Altmýþ beþ yaþ üstü hastalarda komplike kolesistit daha sýk görüldü, ancak istatistiksel olarak anlamlý bir fark yoktu (p=0468).
TARTIÞMA: WBC, CRP ve NLR, komplike akut kolesistiti tahmin etmede deðerli biyokimyasal belirteçlerdir. Ýleri yaþ, komplike kolesistit için yararlý bir prediktif faktör olabilir. Bu faktörler erken kolesistektomi kararý vermede yardýmcý olabilir.