ArticleBMC surgery2025
Preoperative C-reactive protein as a predictor of conversion and complications in laparoscopic cholecystectomy for acute cholecystitis.
Article in BMC surgery, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.
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2 citing papers in PubMed.
- Standard TAPP with flat mesh versus TAPP with flat mesh plus mesh plug for inguinal hernia repair: a preliminary single-center randomized experience.Langenbeck's archives of surgery · 2026Trial
- Comparison of carotid endarterectomy with primary closure versus patch angioplasty.BMC surgery · 2026Article
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2 authors.
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Abstract
introductionLaparoscopic cholecystectomy (LC) is the gold standard for gallbladder surgery but may require conversion to open surgery in complicated cases. While preoperative C-reactive protein (CRP) is known to reflect inflammation, its predictive role in surgical outcomes remains debated. This study evaluated CRP as a predictor of surgical outcomes in acute cholecystitis and uncomplicated gallbladder stones, explicitly excluding choledocholithiasis to isolate gallbladder-specific inflammatory predictors. MATERIALS AND
methodsThis retrospective cohort study analyzed 180 patients undergoing LC for acute cholecystitis (n = 76), chronic cholecystitis (n = 14), or uncomplicated cholelithiasis (n = 90). Preoperative CRP levels were measured, and ROC analysis determined optimal thresholds for predicting conversion and complications (hydrops, necrosis, phlegmon, abscess, bleeding). Due to incomplete albumin data (17.8% missing), the CRP-to-albumin ratio (CAR) could not be robustly analyzed; thus, CRP was the primary focus. Patients with common bile duct (CBD) stones (n = 32) were excluded to eliminate confounding biliary obstruction. Demographic and clinical data of the patients were recorded, and statistical analysis was performed using R software.
resultsAcute cholecystitis patients had higher CRP (25.4 vs. 7.1 mg/L, p < 0.001), longer hospital stays (7.4 vs. 2.2 days, p = 0.001), and more complications (e.g., necrosis: 16.7% vs. 1.1%, p < 0.001). CRP predicted conversion to open surgery with Area Under the Curve (AUC) 0.964 (optimal threshold: 7.5 mg/L, sensitivity 100%) and complications (AUC 0.899-0.983). Chronic cholecystitis patients had lower CRP (4.2 mg/L) and no conversions.
conclusionsCRP demonstrated high accuracy (AUC 0.964) in predicting conversion and complications in acute cholecystitis, with thresholds actionable for surgical planning. Its utility in uncomplicated cholelithiasis is limited.
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