CRP, WBC and monocyte/lymphocyte ratio relation as a preoperative predictive factor for adhesions observed during laparoscopic cholecystectomy

Year 2021, Volume: 4 Issue: 5, 686 - 691, 05.09.2021

Doğukan Durak , Ertugrul Gazi Alkurt , Mehmet Berksun Tutan

https://doi.org/10.32322/jhsm.952507

Cited By: 1

Abstract

Introduction: Inflammation can adversely affect an operation. The ımportant markers of this
inflammation are CRP (C-reactive peptide), WBC (white blood cell).
Aim: The purpose of this study to predict adhesion related technical difficulties during operation
by comparing preoperative CRP, WBC, Monocyte/Lymphocyte ratio and intra-operative adhesion
findings.
Method: This was a retrospective study. This study includes 116 elective and emergency
cholelithiasis cases whose operation performed at Corum Erol Olcok Training and Research
Hospital in 2020 and 2021. Adhesions on gallbladder were graded during operation and divided
into two groups. Groups graded based on intra-operative findings were compared with
preoperative CRP, WBC, and monocyte/lymphocyte ratio.
Results: The patients were divided into two groups based on the adhesion grade as Grade 1-2
(n=84) and Grade 3-4 (n=32). Average WBC count of Grade 3-4 group was average 11.05 ± 4.45
109
/L and this value was statistically significantly higher (p=0.01) than Grade 1-2 group. Average
CRP value of Grade 3-4 group was found as 50.91 ± 77.25 mg/L and this value was significantly
elevated (p<0.001) when compared with Grade 1-2 group. Average monocyte/lymphocyte ratio
was found as 0.29±0.18 and 0.52±0.33 for Grade 1-2 and Grade 3-4 groups, respectively and
these values were found statistically significant (p<0.001). Adhesions were significantly higher for
CRP (>24.5mg/l), WBC (>11.55 109
/L), monocyte/lymphocyte ratio (>0.2693) cut-off values.
Conclusion: Preoperative estimation of adhesion grade helps the surgeon considerably. This
study shows that high CRP, WBC, and Mo/Ly ratio values can help the estimation of intensity of
adhesions and challenges during operation.

Keywords

cholecystectomy, intra-operative adhesion, C-reactive peptide, white blood cell, monocyte/lymphocyte ratio

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