C-Reactive Protein as A Useful Predictor of Difficult Laparoscopic Cholecystectomy

Abstract

Objective: To determine the ability of C-reactive protein as a useful predictor of difficult laparoscopic cholecystectomy. Study Design: Cross sectional study. Place and Duration of Study: General Surgery unit of Combined Military Hospital, Rawalpindi Pakistan, from Nov 2021–Nov 2022. Methodology: Fifty-six patients who underwent emergency or early laparoscopic cholecystectomy were made part of this study. After an informed consent age, gender, Body Mass Index and C-Reactive Protein levels were documented. Patients then underwent surgery and operative time along with “Nassar Difficulty Grade” was documented to define difficult cholecystectomy. Results: A total of 56 patients who were scheduled to undergo laparoscopic cholecystectomy were included with mean age of 44.32±5.37 years. 23(41.10%) were male patients while 33(58.90%) were female patients. Mean CRP levels were 20.00±8.81 mg/L. Frequency of "difficult laparoscopic cholecystectomy" in patients who had high preoperative CRP was 15/22(68.18%) while in patients who had low preoperative CRP it was 13/34(38.23%). Additionally, bivariate analysis of CRP levels and mean operative time showed that Pearson correlation coefficient (r) value was 0.355 showing a significant positive correlation (p=0.007). Conclusion: C-reactive protein levels in patients undergoing laparoscopic cholecystectomy for gallstones or any of its related problems are helpful in predicting whether or not the patient will have a challenging laparoscopic cholecystectomy.