Predictive Ability of Prognostic Markers in Cystic Echinococcosis with Bile Leakage

Objective: The most important post-surgical complication of cystic echinococcosis (CE) is

cystobiliary communication and bile leakage in terms of mortality and morbidity. Therefore,

we aimed to predict bile leakage using prognostic markers before the operation.

Materials and Methods: All patients hospitalized with the diagnosis of CE in the Hepatobiliary

Surgery Service of Atatürk University Research Hospital between 2011 and 2021 were

retrospectively analyzed. Patients who were operated for CE and developed postoperative

leakage were included in the study. Prognostic markers were calculated using preoperative

laboratory tests. And these values were analyzed according to the recovery time of the patient.

Results: The mean recovery time of postoperative biliary fistula was 13.97 ± 7.33 days. No

mortality was observed in the patients. The mean prognostic nutritional index (PNI), the

neutrophil–lymphocyte ratio (NLR) and platelet–lymphocyte ratio (PLR) values were 48.68 ±

8.46, 3.09 ± 2.61, and 149.34 ± 86.17, respectively. PLR significantly affected the recovery times.

An increase in PLR meant a prolonged recovery period. PNI and NLR had no significant effect

on the recovery times of biliary fistula.

Conclusion: In patients with a high PLR value, caution should be exercised in terms of

postoperative biliary fistula. PLR can be used as a marker if the cyst is to be intervened in the

preoperative period.