Department of Hepatobiliary and Pancreatic Surgery, The Second Medical College, Shenzhen People's Hospital, Jinan University, Shenzhen, 518020, Guangdong Province, China.
Department of Operation room, The Second Medical College, Shenzhen People's Hospital, Jinan University, Shenzhen, 518020, Guangdong Province, China.
Sci Rep. 2019 Jul 29;9(1):10976. doi: 10.1038/s41598-019-47501-0.
Difficult laparoscopic cholecystectomy (DLC) is difficult to precisely predict before operation. This observational cohort study aimed to evaluate the predictive value of procalcitonin (PCT) for DLC in patients with acute cholecystitis (AC). A total of 115 patients were included in the study from January 2017 to April 2018. Multiple logistic regression and receiver-operating characteristic (ROC) were performed to evaluate the predictive value of PCT levels in DLC. Patients with DLC had significantly higher Tokyo Guidelines 2018 (TG18) grade (P = 0.002) and levels of C-reactive protein (CRP) (P = 0.007) and PCT (P < 0.001). The cut-off value of PCT for predicting DLC was 1.50 ng/ml. The sensitivity and specificity were 91.3% (95% CI 78.3-97.1) and 76.8% (95% CI 64.8-85.8), respectively. The area under ROC curve was 92.7% (95% CI 88.2-97.3, P < 0.001). Our results suggested that PCT was a good predictor for DLC in the AC patients, but further research is necessary. Monitoring of PCT trends in AC patients may be useful for preoperative risk assessment.
困难性腹腔镜胆囊切除术（DLC）在术前难以准确预测。本观察性队列研究旨在评估降钙素原（PCT）对急性胆囊炎（AC）患者 DLC 的预测价值。本研究共纳入 2017 年 1 月至 2018 年 4 月的 115 例患者。采用多因素逻辑回归和受试者工作特征（ROC）曲线分析评估 PCT 水平对 DLC 的预测价值。DLC 患者的东京指南 2018 版（TG18）分级（P = 0.002）和 C 反应蛋白（CRP）（P = 0.007）和 PCT（P < 0.001）水平显著升高。预测 DLC 的 PCT 截断值为 1.50 ng/ml。其灵敏度和特异性分别为 91.3%（95%CI 78.3-97.1）和 76.8%（95%CI 64.8-85.8）。ROC 曲线下面积为 92.7%（95%CI 88.2-97.3，P < 0.001）。我们的结果表明，PCT 是 AC 患者 DLC 的良好预测指标，但仍需进一步研究。监测 AC 患者 PCT 水平的变化可能有助于术前风险评估。
