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Serum total bilirubin elevation is a predictor of the clinicopathological severity of acute appendicitis

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Abstract

Purpose

Elevation of the serum total bilirubin (STB) level not stemming from hepatic dysfunction or biliary obstruction may be seen in cases of acute appendicitis. This paper deals with the clinical significance of such elevations.

Methods

Data from 410 appendectomized patients classified into two groups (a high preoperative STB group and a normal preoperative STB group) were analyzed to reveal the significance of preoperative hyperbilirubinemia. We also examined whether the preoperative STB level might serve as a risk factor for gangrenous appendicitis by a multivariate analysis.

Results

Gangrenous appendicitis was more common in the high preoperative STB group (p < 0.001). The multivariate analysis revealed that an elevated preoperative STB level (odds ratio 1.7919) was a risk factor for gangrenous appendicitis.

Conclusion

In patients with an elevated preoperative STB level, it is very likely that the inflammation is severe and that the disease has progressed to a severe condition histopathologically; therefore, meticulous attention should be paid to the selection of the surgical procedure, as well as to the postoperative clinical course.

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Authors and Affiliations

  1. Institute of Gastroenterology, Nippon Medical School Musashi Kosugi Hospital, 1-396, Kosugi-cho, Nakahara-ku, Kawasaki, Kanagawa, 211-8533, Japan

    Satoshi Nomura, Masanori Watanabe, Osamu Komine, Tetsutaka Toyoda, Hideki Bou & Hideyuki Suzuki

  2. Department of Surgery, Saitama Citizens Medical Center, Saitama, Japan

    Takeshi Shioya

  3. Department of Surgery, Sayama Chuo Hospital, Sayama, Japan

    Tetsuo Shibuya

  4. Surgery for Organ Function and Biological Regulation, Nippon Medical School Graduate School of Medicine, Tokyo, Japan

    Eiji Uchida

Authors
  1. Satoshi Nomura
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  2. Masanori Watanabe
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  3. Osamu Komine
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  4. Takeshi Shioya
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  5. Tetsutaka Toyoda
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  6. Hideki Bou
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  7. Tetsuo Shibuya
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  8. Hideyuki Suzuki
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  9. Eiji Uchida
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Correspondence to Masanori Watanabe.

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Nomura, S., Watanabe, M., Komine, O. et al. Serum total bilirubin elevation is a predictor of the clinicopathological severity of acute appendicitis. Surg Today 44, 1104–1108 (2014). https://doi.org/10.1007/s00595-013-0659-5

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  • DOI: https://doi.org/10.1007/s00595-013-0659-5

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