Prognostic significance of NLR in acute cholecystitis, treated with laparoscopic cholecystectomy

Acute cholecystitis (AC) is a condition that requires surgical treatment. Laparoscopic cholecystectomy (LC) is considered the gold standard. Based on routine blood tests, it is possible to determine the neutrophil-to-lymphocyte ratio (NLR), which accurately characterizes the body's systemic inflammatory response. The NLR is used as a prognostic tool in many gastrointestinal diseases and may therefore be useful in the diagnosis of AC.

The objective of this study is to assess the prognostic value of the NLR index in the course of AC.

This is a retrospective analysis of patients with AC who underwent LC. The study analyzed the following factors: emergency or elective admission, white blood cell count and bilirubin levels which are the part of preoperative laboratory tests, intraoperative complications such as gallbladder perforation and empyema formation, surgery duration, and length of hospital stay.

The study involved 306 patients treated with LC. In the group of patients with NLR >5, there was a statistically significant correlation with higher risk of emergency admission, elevated bilirubin levels, higher risk of empyema, longer surgery time and hospital stay. We did not find an association between the NLR index and the risk of gallbladder perforation or patient gender.

High NLR values are associated with an increased risk of complications during AC. Therefore, this predictor can be successfully used in clinical practice to identify the severe course of cholecystitis.