Background: Bowel obstruction is a critical emergency. Although imaging like X-ray and CT aids diagnosis, cost-effective hematological biomarkers are still needed. This study evaluates hematological biomarkers for diagnosing complications and prognosis for patients who diagnosed with bowel obstruction.

Methods: A systematic review and meta-analysis was conducted following PRISMA guidelines. We systematically searched Web of Science, PubMed, Scopus, Embase and Cochrane Library for studies published up to June 2025. Inclusion criteria encompassed observational or case-control studies reporting sensitivity/specificity of neutrophil-lymphocyte ratio (NLR), C-reactive protein (CRP), D-dimer, lactate, or procalcitonin (PCT) in bowel obstruction outcomes. Data extraction included true/false, positives/negatives, cutoff values, and ROC parameters. Bivariate models pooled sensitivity/specificity, while summary ROC curves and Youden index determined optimal thresholds. 

Results: This study included 34 articles comprising a total of 5,871 patients. CRP in the diagnosis of bowel ischemia at a cutoff of 26.91 mg/L (Youden index: 0.97), with pooled sensitivity and specificity of 0.80 and 0.92, respectively, and a summary receiver operating characteristic (SROC) curve of 0.91. PCT in the diagnosis of need for surgery achieved a cutoff of 0.12 ng/mL (Youden index: 0.8), with sensitivity and specificity of 0.75 and 0.74 (SROC: 0.79). NLR showed a cutoff of 7.2 (Youden index: 0.68), yielding sensitivity and specificity of 0.74 and 0.83 (AUC: 0.84) in the diagnosis of bowel ischemia. D-dimer (cutoff: 1.72 mg/L, Youden index: 0.91) and lactate (cutoff: 34.3 mmol/L, Youden index: 0.91) exhibited sensitivities of 0.83 and 0.77, specificities of 0.70 and 0.79, and AUCs of 0.85 for both, in the diagnosis of bowel ischemia.

Conclusion: NLR, CRP, D-dimer, PCT and lactate, are promising tools for the diagnosis of bowel ischemia in patients with bowel obstruction. PCT greater than 0.2ng/mL is promising tool for the need of surgical intervention. 

PROSPERO registration number: CRD420251040834. 

**Dr. Yunhong Tian: A Distinguished Surgeon and Innovator in Gastrointestinal and Metabolic Surgery**  

**Professional Overview**  

Dr. Yunhong Tian is a renowned surgeon, researcher, and academic leader specializing in gastrointestinal oncology, bariatric/metabolic surgery, and hernia repair. As the *Deputy Director of Surgery*, *Director of the Gastrointestinal and Hernia Surgery Department*, and *Chief Physician* at Nanchong Central Hospital, he combines clinical excellence with groundbreaking research to advance minimally invasive surgical techniques and improve patient outcomes.  

**Education and Global Training**  

Dr. Tian’s academic journey reflects his commitment to excellence:  

- **Medical Degree**: Bachelor of Medicine, Luzhou Medical College (2000–2005).  

- **Residency**: Practiced at Sichuan Daying County People’s Hospital (2005–2009).  

- **Master’s Degree**: Internal Medicine, North Sichuan Medical College (2009–2012).  

- **Doctorate**: Clinical Medicine, Soochow University (2015–2018), trained at Shanghai Eastern Hepatobiliary Surgery Hospital.  

- **International Expertise**:  

  - Visiting Scholar at Wayne State University, USA (2016).  

  - "Western Light" Scholar at Shanghai Xinhua Hospital (2017–2018).  

  - Research training at Texas Medical Center, USA.  

**Clinical Expertise**  

Dr. Tian is celebrated for his proficiency in:  

- **Minimally Invasive Techniques**: Pioneer of single-incision laparoscopic gastrectomy and robotic-assisted surgeries.  

- **Bariatric Surgery**: Expertise in laparoscopic sleeve gastrectomy and gastric bypass for obesity/metabolic syndrome.  

- **Innovative Protocols**: Developed the *GAM intraoperative leak-testing procedure*, significantly reducing postoperative complications in gastric cancer surgeries.  

- **Complex Hernia Repairs**: Advanced methods for inguinal, femoral, and hiatal hernias.  

- **Reflux and Motility Disorders**: Mastery of Nissen/Toupet fundoplication and Heller myotomy for achalasia.  

**Academic and Research Leadership**  

- **Publications**: Authored 40+ peer-reviewed papers, including 10+ SCI-indexed articles as lead/corresponding author.  

- **Editorial Roles**: Reviewer for *Surgical Endoscopy* and *Western Medical Journal*.  

- **Awards**:  

  - *2021 Sichuan Medical Youth Science Award* (1st rank, Applied Research).  

  - *Top Ten Innovative Talents* at Nanchong’s "Jiaying Innovation Competition" (2021).  

  - *2023 Nanchong Technological Innovation Award* (3rd prize, 2nd rank).  

- **Books**:  

  - *Chief Translator*: *Innovative Techniques in Digestive Surgery and Endoscopy* (ISBN: 9787543344624).  

  - *Deputy Editor*: *Bioinformatics in Medical Research* (ISBN: 978-7-5433-4611-6).  

**Research Grants**  

Dr. Tian has led 10+ provincial/municipal projects, including:  

- *CDCA5-ERK Regulation in Hepatocellular Carcinoma* (Sichuan Science & Technology Program, 2017).  

- *Targeted Therapy for Colon Cancer with Fangchinoline* (Nanchong Collaborative Grant, 2020).  

- *Multicenter RCT on Anastomotic Reinforcement in Gastric Surgery* (Wu Jieping Medical Foundation, 2024).  

- *Sichuan Provincial Key Clinical Specialty Construction* (3M RMB funding, 2024).  

**Professional Affiliations**  

- **Current**:  

  - Vice Chair, Sichuan International Medical Exchange Association for GERD.  

  - Standing Committee Member, Sichuan Obesity & Metabolic Surgery Association.  

  - Director, Nanchong General Surgery Quality Control Center.  

- **Past**:  

  - Committee Member, Chinese Medical Association Micro-Invasive Surgery Branch.  

**Philosophy and Vision**  

Dr. Tian’s work embodies a fusion of precision surgery, translational research, and education. As a *Mentor* for postgraduate students and a *Clinical Skills Instructor* recognized by Sichuan Province, he cultivates the next generation of surgeons. His mission is to bridge technological innovation with compassionate care, ensuring each patient benefits from the latest advancements in gastrointestinal and metabolic surgery.