Role of serum procalcitonin in predicting the surgical outcomes of acute calculous cholecystitis

Pietro Fransvea, Marcello Covino, Fausto Rosa, Caterina Puccioni, Giuseppe Quero, Valerio Cozza, Antonio La Greca, Francesco Franceschi, Sergio Alfieri, Gabriele Sganga

Research output: Contribution to journalArticlepeer-review


Background: Acute calculous cholecystitis (AC) is a syndrome of right upper quadrant pain, fever, and leukocytosis associated with gallbladder inflammation. In the preoperative planning, the severity of AC should be considered as well as time of onset of symptoms and patient comorbidities. The aim of the present study was to investigate the role of an early PCT assessment in the emergency department in predicting the outcomes of laparoscopic surgery for AC. Study design: Retrospective, mono-centric study conducted in a teaching urban hospital. We evaluated all patients admitted to our ED from January 1st, 2015, to December 31st, 2019, underwent laparoscopic cholecystectomy for AC having a preoperative PCT determination in ED. Results: A total of 2285 patients in our ED were admitted for AC. Among them 822 patients were treated surgically, 174 had a PCT determination in ED. Median age was 63 [50–74]. Overall, 33 patients (19.0%) had major complications (MC): 32 needed an open surgery conversion, and 3 among them deceased. Multivariate analysis demonstrated that PCT, WBC, BUN, and CCI were significantly associated to MC in our cohort. When we calculated the area under the ROC curve with regard to MC, a procalcitonin value > 0.09 at admission had sensitivity = 84.8% [68.1–94.9] and specificity = 51.8% [43.2–60.3] for the occurrence of MC. Conclusion: Our results, suggest that a PCT > 0.09 ng/mL at ED admission, could be associated to a poor surgical outcome in patients treated by laparoscopic surgery for AC.

Original languageEnglish
Pages (from-to)2375-2382
Number of pages8
JournalLangenbeck's Archives of Surgery
Issue number7
Publication statusPublished - Nov 2021


  • Acute cholecystitis
  • Procalcitonin
  • Surgical outcomes

ASJC Scopus subject areas

  • Surgery


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