The incidence of postoperative complications of laparoscopic calculous cholecystitis and the predictive efficacy of serum GGT/ALP ratio
Objective To investigate the incidence of postoperative complications of laparoscopic calculous cholecystitis and the predictive efficacy of serum amma-glutamyltranspeptidase/alkaline phosphatase(GGT/ALP)ratio.Methods A total of 124 cases of calculous cholecystitis who received laparoscopic chole-cystectomy at Shandong University Qilu Hospital Dezhou Hospital from November 2021 to October 2023 were retrospectively selected.They were divided into two groups:a complication group(n=12)and a non-complica-tion group(n=112)based on whether complications occurred within 28 days after surgery.The influencing fac-tors of postoperative complications for laparoscopic calculous cholecystitis were explored using multivariate lo-gistic stepwise regression analysis.Serum levels of GGT and ALP,and GGT/ALP ratio,were compared be-tween the two groups.The predictive value of GGT,ALP,and the GGT/ALP ratio for postoperative complica-tions in patients with laparoscopic calculous cholecystitis was evaluated using ROC analysis.Results The com-plication rate of 124 patients with laparoscopic cholecystitis was 9.68%(12/124).The proportion of patients aged≥60 years,with a history of abdominal surgery,gallbladder wall thickness≥5 mm,gallbladder triangle ad-hesion,gallbladder triangle variation,operation time≥48 h,and preoperative WBC level≥15×109 in the com-plication group was higher than that in the non-complication group,with statistical significance(P<0.05).Gall-bladder wall thickness≥5 mm,gallbladder triangle adhesion,gallbladder triangle variation and preoperative WBC level≥15×109 were identified as independent risk factors for postoperative complications in cases of lapa-roscopic cholecystitis(P<0.05).The levels of serum GGT,ALP,and GGT/ALP ratio in the complication group were higher than those in the non-complication group,with statistical significance(P<0.05).The area un-der the curve(AUC)predicted by GGT and ALP for postoperative complications in patients with laparoscopic calculous cholecystitis were 0.852 and 0.747,respectively,which were lower than that predicted by the GGT/ALP ratio(0.901).Conclusion The GGT/ALP ratio has a certain predictive value for postoperative complica-tions in cases of laparoscopic calculous cholecystitis and can be used as a potential predictive marker.
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