Prospective analysis of preoperative C-reactive protein and neutrophil-to-lymphocyte ratio as predictors of postoperative complications in bile duct injury repair.

Abstract

The role of inflammation in the bile duct injury has been suggested. Regarding, this study aims to determine the relationship between preoperative White Blood Cell count (WBC), C-reactive protein (CRP), and neutrophil-lymphocyte ratio (pNLR) with post-operative short- and long-term outcomes in patients undergoing a hepaticojejunostomy (HJ) for a bile duct injury (BDI) repair. This prospective longitudinal study (R-2022-3001-127) enrolled fifty patients. pNLR, WBC, and CRP were determined from preoperative laboratory analysis. Morbidity/Mortality, Accordion and National Surgical Quality Improvement Program (NSQIP), primary HJ patency and actual primary patency rate were registered. Perioperative morbidity and mortality were 34% and 2%. Primary patency was 92%. Median CRP and pNLR were statistically significantly higher in patients with Accordion > 3, NSQIP any complication, and biliary complications. CRP cut-off was consistent (6.3-6.6 mg/dl) with area under curve (AUC) 0.8, in all post-operative complications. pNLR had a good AUC (0.7; 2.7-3.1 cut-off value) in any complication and biliary complications. Preoperative inflammatory biomarkers of patients who underwent a HJ for BDI repairs were associated with post-operative complications.