Post-operative procalcitonin and C-reactive protein predict pancreatic fistula after laparoscopic pancreatoduodenectomy

BMC Surgery

Yahui Liu¹  Peiqiang Jiang¹  Bai Ji¹  Jie Ma²  Yanqing Song² 

[1] Department of Hepatobiliary and Pancreatic Surgery, First Hospital of Jilin University, No. 1 Xinmin Road, 130021, Changchun, Jilin, China;Department of Pharmacy, First Hospital of Jilin University, No. 1 Xinmin Road, 130021, Changchun, Jilin, China;

关键词: Laparoscopic pancreaticoduodenectomy;    Pancreatic fistula;    Procalcitonin;    C-reactive protein;   

DOI  :  10.1186/s12893-021-01177-4

来源: Springer

【 摘 要 】

BackgroundClinically relevant pancreatic fistula (CRPF) is a serious complication following laparoscopic pancreaticoduodenectomy (LPD). This study aimed to determine if C-reactive protein (CRP) and procalcitonin (PCT) serum levels could be used as early biomarkers to predict CRPF after LPD.MethodsIn this retrospective study, we collected peri-operative data of patients who underwent LPD between January 2019 and November 2019. We compared serum levels of white blood cells (WBC), CRP, and PCT on post-operative days (POD) 1, 2, 3, 5, and 7 between the CRPF and non-CRPF groups and analyzed the predictive risk factors for CRPF.ResultsAmong the 186 patients included in this study, 18 patients (9.7%) developed CRPF, including 15 and 3 patients with grade B and C fistulas, respectively. The mean WBC, CRP, and PCT levels were higher on most PODs in the CRPF group compared to the non-CRPF group. Receiver operating characteristic (ROC) analysis indicated that CRP levels on POD 2, 5, and 7 can predict CRPF development after LPD, with the area under the curve (AUC) value reaching the highest level on POD 2 (AUC 0.794). PCT levels on POD 2, 3, 5, and 7 were highly predictive of CRPF after LPD. The highest AUC value was achieved on POD 3 [PCT > 2.10 ng/ml (AUC 0.951; sensitivity 88.2%, specificity 92.9%, P < 0.001)].ConclusionsBoth CRP and PCT levels can be used to predict CRPF development after LPD, with PCT having a higher predictive value.

【 授权许可】

CC BY