Is C-reactive protein the single most useful predictor of difficult laparoscopic cholecystectomy or its conversion? A pilot study
Introduction: Both converted and difficult laparoscopic cholecystectomies (LC) have impact on operating time and training of juniors. The aim of this study is to evaluate parameters that predict difficult LC or conversion (C), and find predictive values for different cut-off points of C-reactive pro...
| Main Authors: | , , , |
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| Format: | Article |
| Language: | English |
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Wolters Kluwer Medknow Publications
2016-01-01
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| Series: | Journal of Minimal Access Surgery |
| Subjects: | |
| Online Access: | http://www.journalofmas.com/article.asp?issn=0972-9941;year=2016;volume=12;issue=1;spage=26;epage=32;aulast=Jessica |
| _version_ | 1818253562739687424 |
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| author | Kam Wa Jessica Mok Yan Li Goh Laura E Howell Ravindra S Date |
| author_facet | Kam Wa Jessica Mok Yan Li Goh Laura E Howell Ravindra S Date |
| author_sort | Kam Wa Jessica Mok |
| collection | DOAJ |
| description | Introduction: Both converted and difficult laparoscopic cholecystectomies (LC) have impact on operating time and training of juniors. The aim of this study is to evaluate parameters that predict difficult LC or conversion (C), and find predictive values for different cut-off points of C-reactive protein (CRP) for conversion. Materials and Methods: A retrospective cohort study of cholecystectomies performed from January 2011 to December 2012 at NHS trust was undertaken. Association of intra-operative difficulties or conversion with the following factors was studied: Age, gender, CRP, white blood cell count (WBC), history of pancreatitis, and endoscopic retrograde cholangiopancreatography (ERCP). Results: Two hundred and ninety one patients were analysed (222 laparoscopic, 45 difficult LC and 24 C). Only 141 patients had a recorded CRP. Median CRP was highest for patients who were converted (286.20) compared to those who had difficult LC (67.40) or LC (7.05). Those patients who did not have preoperative CRP (8/150, 5.3%) had less chance of conversion than those who had CRP (16/141, 11.34%) (P = 0.063). Patients with CRP of ≤220 (3/91, 3.2%) had significantly less chance of conversion than those with CRP >220 (13/21, 61.9%) (P < 0.001). High preoperative CRP, WBC count and ERCP, were predictors of conversion. These factors were only marginally better than CRP alone in predicting conversion. Conclusion: CRP can be a strong predictor of conversion of LC. Further validation of the results is needed. |
| first_indexed | 2024-12-12T16:42:03Z |
| format | Article |
| id | doaj.art-7ec32a44fff94026a0233eee531b1969 |
| institution | Directory Open Access Journal |
| issn | 0972-9941 1998-3921 |
| language | English |
| last_indexed | 2024-12-12T16:42:03Z |
| publishDate | 2016-01-01 |
| publisher | Wolters Kluwer Medknow Publications |
| record_format | Article |
| series | Journal of Minimal Access Surgery |
| spelling | doaj.art-7ec32a44fff94026a0233eee531b19692022-12-22T00:18:32ZengWolters Kluwer Medknow PublicationsJournal of Minimal Access Surgery0972-99411998-39212016-01-01121263210.4103/0972-9941.158963Is C-reactive protein the single most useful predictor of difficult laparoscopic cholecystectomy or its conversion? A pilot studyKam Wa Jessica MokYan Li GohLaura E HowellRavindra S DateIntroduction: Both converted and difficult laparoscopic cholecystectomies (LC) have impact on operating time and training of juniors. The aim of this study is to evaluate parameters that predict difficult LC or conversion (C), and find predictive values for different cut-off points of C-reactive protein (CRP) for conversion. Materials and Methods: A retrospective cohort study of cholecystectomies performed from January 2011 to December 2012 at NHS trust was undertaken. Association of intra-operative difficulties or conversion with the following factors was studied: Age, gender, CRP, white blood cell count (WBC), history of pancreatitis, and endoscopic retrograde cholangiopancreatography (ERCP). Results: Two hundred and ninety one patients were analysed (222 laparoscopic, 45 difficult LC and 24 C). Only 141 patients had a recorded CRP. Median CRP was highest for patients who were converted (286.20) compared to those who had difficult LC (67.40) or LC (7.05). Those patients who did not have preoperative CRP (8/150, 5.3%) had less chance of conversion than those who had CRP (16/141, 11.34%) (P = 0.063). Patients with CRP of ≤220 (3/91, 3.2%) had significantly less chance of conversion than those with CRP >220 (13/21, 61.9%) (P < 0.001). High preoperative CRP, WBC count and ERCP, were predictors of conversion. These factors were only marginally better than CRP alone in predicting conversion. Conclusion: CRP can be a strong predictor of conversion of LC. Further validation of the results is needed.http://www.journalofmas.com/article.asp?issn=0972-9941;year=2016;volume=12;issue=1;spage=26;epage=32;aulast=JessicaC-reactive proteindifficult dissectionlaparoscopic cholecystectomypredicting conversion |
| spellingShingle | Kam Wa Jessica Mok Yan Li Goh Laura E Howell Ravindra S Date Is C-reactive protein the single most useful predictor of difficult laparoscopic cholecystectomy or its conversion? A pilot study Journal of Minimal Access Surgery C-reactive protein difficult dissection laparoscopic cholecystectomy predicting conversion |
| title | Is C-reactive protein the single most useful predictor of difficult laparoscopic cholecystectomy or its conversion? A pilot study |
| title_full | Is C-reactive protein the single most useful predictor of difficult laparoscopic cholecystectomy or its conversion? A pilot study |
| title_fullStr | Is C-reactive protein the single most useful predictor of difficult laparoscopic cholecystectomy or its conversion? A pilot study |
| title_full_unstemmed | Is C-reactive protein the single most useful predictor of difficult laparoscopic cholecystectomy or its conversion? A pilot study |
| title_short | Is C-reactive protein the single most useful predictor of difficult laparoscopic cholecystectomy or its conversion? A pilot study |
| title_sort | is c reactive protein the single most useful predictor of difficult laparoscopic cholecystectomy or its conversion a pilot study |
| topic | C-reactive protein difficult dissection laparoscopic cholecystectomy predicting conversion |
| url | http://www.journalofmas.com/article.asp?issn=0972-9941;year=2016;volume=12;issue=1;spage=26;epage=32;aulast=Jessica |
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