Relationship between C-Reactive Protein (CRP) and Erythrocyte Sedimentation Rate (ESR) with gall bladder adhesion on cholecystectomy at Abdul Wahab Sjahranie Hospital, Samarinda

Abstract

Background: The conversion from laparoscopic cholecystectomy to open cholecystectomy often results from pericholecystic Adhesion. Pericholecystic Adhesion is a result of cholecystitis in the case of cholelithiasis. C-Reactive Protein (CRP) and Erythrocyte Sedimentation Rate (ESR) can be increased in cholecystitis and used as a predictive factor for the degree of difficulty in laparoscopic cholecystectomy. This study aims to determine the relationship between CRP and ESR with gall bladder adhesion on cholecystectomy at Abdul Wahab Sjahranie Hospital, Samarinda.Method: A cross-sectional study was conducted among 61 respondents who underwent a cholecystectomy surgery at Abdul Wahab Sjahranie Hospital Samarinda during July-September 2019. Parameters assessed in this study were Gender, diagnosis, CRP, ESR, age, hemoglobin, leukocytes count, platelet count, and the relationship between CRP and ESR value with the pericholecystic adhesions. Data were analyzed by SPSS version 22 for Windows. Results: Most of respondents were female (70.5%), followed by cholelithiasis (73.8%) as primary diagnosis, no Pericholecystic Adhesions found (68.9%), CRP level < 23 mg/dl (77.0%), and ESR level ≥ 11 mm/hour (78.7%). In addition, the average age of respondents was 48.44±10.85 years old, followed by the hemoglobin level (12.43±1.77 g/dL), leukocytes counts (9,439.67±3,719.37/µl), and platelet counts (319,295.08 ± 90,587.59/ µl). CRP level had a significant relationship to the occurrence of pericholecystic Adhesion (OR: 75.400; 95%CI: 7.991-711.441; p=0.000).Conclusion: It can be concluded that there was a relationship between CRP and ESR with the occurrence of pericholecystic Adhesion. However, based on multivariate analysis, CRP was more significant compared to ESR on the occurrence of pericholecystic Adhesion.