2022 Volume 56 Issue 4 Pages 146-154
Background: The association between preoperative Prognostic Nutrition Index/Controlling Nutritional Status （PNI/CONUT） score and postoperative complications for cholecystitis is unclear. We evaluated the association among preoperative clinical status, including Charlson Comorbidity Index, American Society of Anesthesiologists‐physical status classification system （ASA‐PS）, Tokyo Guidelines 2018 （TG2018） severity grade, PNI, and CONUT, and postoperative complications for patients undergoing surgical treatment for cholecystitis.
Results: Sixty‐seven patients undergoing surgery for cholecystitis diagnosed by TG2018 were enrolled in this study. Sixty patients underwent laparoscopic cholecystectomy （42 were completed by laparoscopic and 18 were converted to open surgery）, and seven patients underwent initially open cholecystectomy. Nine patients had postoperative complications （Clavien‐Dindo Grade Ⅲ or more）. There was a significant association between postoperative complications and being in the preoperative low‐PNI （＜40） group compared with the high‐PNI （≥40） group （78％ vs. 22％, p＝0.038）, and being in the preoperative high‐CONUT group （score ≥5, moderate and severe） compared with being in the low‐CONUT group （score ≤4, normal and light） （67％ vs. 33％, p＝0.043）. There was no significant association between postoperative mortality （n＝2） and preoperative factors；however, the patients had low PNI （＜40）. Preoperative body mass index, albumin, total lymphocytes, and total cholesterol were not significantly associated with postoperative complications or mortality.
Conclusion: Evaluation of preoperative PNI and CONUT may be predictive factors for postoperative complications undergoing surgery for cholecystitis.
