C-reactive Protein Levels as A Predictor of Difficult Laparoscopic Cholecystectomy

Abstract

Objective: To determine the mean C-reactive protein (CRP) levels preoperatively among patient with Acute Cholecystitis to predict difficulty of Laparoscopic Cholecystectomy on Nassar Grade.

Methodology: This cross-sectional study was conducted in General Surgery Department, PAEC General Hospital, Islamabad from 30/01/2023 to 31/07/2023

This study was conducted in the Department of General Surgery, PAEC General Hospital, Islamabad. 150 patients having symptomatic gallstones were enrolled in the study. CRP level was determined preoperatively in all patients. All patients underwent LC. Intraoperative difficulty level was determined using the Nassar grade. Mean CRP level was compared between the 5 grades Nasser scale, by applying ANOVA test keeping p-value ? 0.05 as significant.

Results: A total of 150 patients with symptomatic gallstones were enrolled for the study. The mean age of the patients was 47.29+/-13.75 years. 34 (22.7%) were male and 116 (77.3%) were female. The mean WBC count of our patients was 9075.27+/-3437.46/µL. The mean CRP level of our patients was 31.01+/-61.32 mg/dL. The mean CRP level was significantly higher in patients with grade 4, followed by grade 3, grade 2 and grade 1 (p-value < 0.01).

Conclusion: Our study concluded that there is a significant link between higher CRP levels and increased Nassar grades, indicating a positive relationship between elevated CRP levels and greater intraoperative difficulty during LC.