Abstract

CLAROS, BN et al. POSITIVE PREDICTIVE VALUE OF SERUM PROCALCITONIN AS A MARKER OF GALLBLADDER INFECTION AND INITIATION OF ANTIBIOTIC TREATMENT IN PATIENTS WITH ACUTE LITHIASIC CHOLECYSTITIS. Cuad. - Hosp. Clín. [online]. 2025, vol.66, n.1, pp.11-18.  Epub Sep 23, 2025. ISSN 1562-6776.

INTRODUCTION: The routine use of antibiotic in acute cholecystitis (AC) is controversial.

OBJETIVE: To determine the positive predictive value (PPV) of serum procalcitonin as a marker of gallbladder infection in an acute cholecystitis (AC).

RESEARCH METHODOLOGY: Diagnostic Test

RESULTS: 147 patients were included with an average age of 46.7 years, divided into 73 female (49.7%) and 74 male (50.3%). In the clinical picture, 128 patients (87.1%) presented positive Murphy's sign and 127 (86.4%) presented muscle contracture. The average gallbladder wall thickness on ultrasonography was 5.6 mm. Presence of perivesicular fluid in 8 patients (5.4%). The leukocyte counts averaged 8656 white blood cells per mm3, and a percentage neutrophil count of 74.9.

The average dosage of PCT was 0.23(0.2 ng/ml. The average surgical time in minutes was 50. In 57 patients (38.8%) there was accidental spillage or premeditated puncture of the gallbladder. The percentage of conversion to open surgery in 3 patients (2%). 24 patients with positive bile culture were described (16.32%). The calculated sensitivity for calcitonin as a marker of bacterial infection in the gallbladder was 25% and a specificity of 74%. The positive and negative predictive values ​​were 46% and 53% respectively, with positive and negative likelihood ratios of 0.96 and 1.01 respectively.

CONCLUSION: The positive predictive value of PCT as an indicator of gallbladder infection during CA is only 46%.

Keywords : Procalcitonin; gallbladder infection; acute cholecystitis.

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