title: Elevated plasma visfatin levels correlate with conversion of laparoscopic cholecystectomy to open surgery in acute cholecystitis.
abstract: Visfatin correlates with inflammation and its levels in peripheral blood are associated with some inflammatory diseases. This study aimed to assess the relationship between plasma visfatin levels and conversion of laparoscopic cholecystectomy to open surgery in acute cholecystitis. One hundred and forty-six acute cholecystitis patients and 146 sex- and age-matched healthy controls were recruited and their plasma visfatin levels were determined using an enzyme immunoassay. 17 patients (11.6%) underwent conversion. Plasma visfatin levels were statistically significantly elevated in all patients (97.2±41.8ng/mL), those with (161.4±71.3ng/mL) or without conversion (88.7±26.9ng/mL), compared to controls (40.3±13.3ng/mL, all P<0.001). A linear regression analysis showed that plasma visfatin levels were positively associated with plasma C-reactive protein levels (t=0.510, P<0.001). A logistic-regression analysis showed that age [odds ratio (OR) 1.160, 95% confidence interval (CI) 1.011-1.332, P=0.035] and plasma visfatin levels (OR 1.035, 95% CI 1.005-1.066, P=0.022) appeared to be the independent predictors of conversion. A receiver operating characteristic curve analysis found that plasma visfatin levels predicted conversion with high area under curve (AUC) (AUC, 850; 95% CI, 0.781-0.903). The AUC of the visfatin concentration was similar to that of age (AUC, 0.738; 95% CI, 0.659-0.807) (P=0.188). Visfatin improved the AUC of age to 0.914 (95% CI, 0.856-0.954) (P=0.011) using a combined logistic-regression model. Thus, high plasma levels of visfatin are associated with systemic inflammation, and may independently predict conversion of laparoscopic cholecystectomy to open surgery in acute cholecystitis.
authors.affiliation: Department of General Surgery, The Yinzhou Second People's Hospital, Branch Hospital of The First Affiliated Hospital of Medical School of Zhejiang University, 1 Qianhe Road, Ningbo 315192, China.
authors.forename: Kai-Gang
authors.initials: KG
authors.lastname: Xie
authors.affiliation: Department of General Surgery, The Yinzhou Second People's Hospital, Branch Hospital of The First Affiliated Hospital of Medical School of Zhejiang University, 1 Qianhe Road, Ningbo 315192, China.
authors.forename: Xiao-Ping
authors.initials: XP
authors.lastname: Teng
authors.affiliation: Department of General Surgery, The Yinzhou Second People's Hospital, Branch Hospital of The First Affiliated Hospital of Medical School of Zhejiang University, 1 Qianhe Road, Ningbo 315192, China.
authors.forename: Shui-Yin
authors.initials: SY
authors.lastname: Zhu
authors.affiliation: Department of General Surgery, Health Center, 6 Wenwei Road, Qiuai town, Ningbo 315101, China.
authors.forename: Xiong-Bo
authors.initials: XB
authors.lastname: Qiu
authors.affiliation: Department of General Surgery, The Yinzhou Second People's Hospital, Branch Hospital of The First Affiliated Hospital of Medical School of Zhejiang University, 1 Qianhe Road, Ningbo 315192, China.
authors.forename: Xiao-Ming
authors.initials: XM
authors.lastname: Ye
authors.affiliation: Department of General Surgery, The Yinzhou Second People's Hospital, Branch Hospital of The First Affiliated Hospital of Medical School of Zhejiang University, 1 Qianhe Road, Ningbo 315192, China. Electronic address: gaochencg@163.com.
authors.forename: Xiao-Ming
authors.initials: XM
authors.lastname: Hong
mesh_terms: D000368:Aged; D017081:Cholecystectomy, Laparoscopic; D041881:Cholecystitis, Acute / Q000097:blood* / Q000601:surgery*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D054409:Nicotinamide Phosphoribosyltransferase / Q000097:blood*; D011446:Prospective Studies; D012372:ROC Curve
chemical_list: D054409:Nicotinamide Phosphoribosyltransferase
keywords: Acute cholecystitis; Conversion; Laparoscopic cholecystectomy; Open surgery; Visfatin