Significancia pronóstica del NLR en la colecistitis aguda, tratada con colecistectomía laparoscópica
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Jakub Pośpiech1, Katarzyna A Kowalczyk2, Tomasz Stefura3
1Faculty of Medicine, Jagiellonian University Collegium Medicum, Kraków, Poland; jakub.pospiech001@gmail.com.
Folia medica Cracoviensia
|September 3, 2025
Resumen
La relación entre neutrófilos y linfocitos (RNL) puede predecir las complicaciones de la colecistitis aguda (CA). Los valores altos de NLR se correlacionan con un mayor riesgo de ingreso de emergencia, empema y estadías hospitalarias más largas después de la colecistectomía laparoscópica (LC).
Área de la Ciencia:
- Gastroenterología
- Oncología quirúrgica
- Los marcadores inflamatorios
Sus antecedentes:
- La colecistitis aguda (AC) requiere intervención quirúrgica, siendo la colecistectomía laparoscópica (LC) el tratamiento estándar.
- La proporción de neutrófilos a linfocitos (RNL) cuantifica la inflamación sistémica y es una herramienta de pronóstico en enfermedades gastrointestinales.
- La utilidad potencial del NLR en el diagnóstico y la predicción de la gravedad del AC justifica una investigación.
Objetivo del estudio:
- Evaluar el pronóstico significativo de la relación neutrófilos/ linfocitos (RNL) en pacientes diagnosticados con colecistitis aguda (CA).
- Para determinar si el NLR puede predecir la gravedad y las complicaciones asociadas con el AC.
Principales métodos:
- Análisis retrospectivo de 306 pacientes que se sometieron a colecistectomía laparoscópica (LC) por colecistitis aguda (AC).
- Análisis de las pruebas de laboratorio preoperatorias (número de glóbulos blancos, bilirrubina), tipo de ingreso (emergencia/electivo), complicaciones intraoperatorias (perforación, empema), duración de la cirugía y estancia hospitalaria.
- Correlación de la relación neutrófilos/ linfocitos (RNL) con los resultados clínicos.
Principales resultados:
- Una proporción de neutrófilos/ linfocitos (NLR) superior a 5 se asoció significativamente con tasas más altas de ingreso de emergencia.
- Un NLR elevado se correlacionó con un mayor riesgo de empema, niveles más altos de bilirrubina y una mayor duración de la cirugía y la hospitalización.
- No se encontró una asociación significativa entre la NLR y la perforación de la vesícula biliar o el sexo del paciente.
Conclusiones:
- Los valores elevados de la relación neutrófilos/ linfocitos (RNL) indican un mayor riesgo de complicaciones en la colecistitis aguda (CA).
- El NLR sirve como un predictor clínico valioso para identificar casos graves de colecistitis, ayudando en el manejo del paciente.
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