Abstract
OBJECTIVE: Acute cholecystitis (AC) is one of the most common causes of hospital admissions due to abdominal pain. Early diagnosis and prompt initiation of treatment positively impact morbidity and mortality in AC. The aim of our study was to determine serum and urine concentrations of additional biomarkers at different stages of the disease, beyond those currently used in acute cholecystitis severity staging, and to evaluate their potential inclusion as new staging parameters. METHODS: This study prospectively analyzed data from 63 patients diagnosed with acute cholecystitis and treated by the same surgical team in 2020. In patients with AC, WBC, CRP, and PCT values, as outlined in the TG18 guidelines, showed an increasing trend. These values are commonly used to determine disease stage. RESULTS: A correlated increase in these infectious parameters was observed as disease severity progressed. The mean S-NEO value in Stage 1-2 patients was 20.082 ± 9.517 nmol/L, while the mean U-NEO value was 3.46 ± 2.95 µmol/L. In Stage 3 patients, the mean S-NEO value was 40.92 ± 7.878 nmol/L, and the mean U-NEO value was 4.4 ± 2.42 µmol/L. The Mann-Whitney U test revealed a significant difference in S-NEO values between Stage 1-2 and Stage 3 groups (p < 0.001). However, no significant difference was observed between these groups in terms of U-NEO values (p = 0.18). CONCLUSION: In patients with acute cholecystitis, S-NEO and U-NEO levels can serve as complementary biomarkers alongside existing diagnostic and staging parameters. Particularly in staging severity, S-NEO levels may play a crucial role in early diagnosis and timely initiation of treatment, given their high specificity and sensitivity at defined cut-off values.