Changes of DBIL,TBIL,and inflammatory factors in perioperative period of laparoscopic cholecystectomy and construction of a risk prediction model for postoperative complications
Changes of DBIL,TBIL,and inflammatory factors in perioperative period of laparoscopic cholecystectomy and construction of a risk prediction model for postoperative complications
Objective:To investigate the changes of direct bilirubin,total bilirubin(TBIL),and inflammatory factors in peri-operative period of laparoscopic cholecystectomy(LC),and to construct a risk prediction model for postoperative complications of LC based on these findings.Methods:From Jan.2022 to May 2023,296 patients who underwent LC were selected.Medical records of all patients were collected.Serum direct bilirubin,TBIL,and inflammatory factors were analyzed before and after operation.Patients were divided into the complication group and the non-complication group according to whether there were complications within 1 month after surgery.Univariate analysis and multivariate logistic regression model analysis were performed,and a risk prediction model was con-structed.Results:Serum direct bilirubin,TBIL,interleukin-6,tumor necrosis factor-α,and C-reactive protein in complication group were higher than those in non-complication group at all time points before and after operation(P＜0.05).Age,body mass index,gallbladder wall thickness,the proportions of gallbladder adhesion to surrounding organs,Calot triangle adhesion,gallbladder neck calculus,and his-tory of diabetes in the complication group were higher than those in the non-complication group(P＜0.05).Logistic regression results showed that age,diabetes history,gallbladder wall thickness,gallbladder adhesion to surrounding organs,and preoperative levels of serum TBIL,interleukin-6,tumor necrosis factor-α,and C-reactive protein were all independent risk factors for complications after LC(P＜0.05).The analysis of the receiver operating characteristic curve showed that the area under the curve was 0.756(95％CI=0.658～0.825,P＜0.05).Conclusions:Elevated levels of TBIL,interleukin-6,tumor necrosis factor-α,and C-reactive protein before surgery have been identified as independent risk factors for complications after LC.The predictive model developed by these factors demon-strates significant value in forecasting complications following LC in patients with gallbladder disease.
维普
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