C-Reactive Protein and Procalcitonin as Predictors of Postoperative Inflammatory Complications After Pancreatic Surgery

Abstract

CRP and PCT concentration were associated with an increased risk of developing complications and clinical relevant pancreatic fistula after PD. Use of these biomarkers may help identify those patients at highest risk for perioperative morbidity and help guide postoperative management of patients undergoing PD.

Role of post‐operative serum C‐reactive protein levels as a predictor of complications in upper gastrointestinal surgery

“…In this series, measurement of CRP was most accurate in patients undergoing pancreatectomy . However, it was less useful in patients undergoing oesophagectomy which may reflect the relatively small numbers ( n = 30) in this investigation.…”

“…Plasma levels of CRP normally rise immediately after surgical intervention and, in uncomplicated patients, return towards normal levels within 48 h (one to two half‐lives) of skin closure . CRP has been used as a marker of anastomotic leak and intra‐abdominal collection in colorectal surgery and has also been investigated as a marker of post‐operative sepsis in patients following oesophagectomy, gastrectomy and pancreatectomy, although it is less well studied in post‐hepatectomy patients. However, the exact role of CRP in the prediction of post‐operative complications in UGI surgery remains unclear.…”

“…Similarly, uncertainty exists regarding the critical time to measure CRP following surgery. In patients undergoing gastric resection, elevations of CRP on days 2 or 4 post‐resection may predict anastomotic leak, and following pancreatic resections, elevations on day 1 or day 7 post‐operation may predict a pancreatic leak …”

Neutrophil: Lymphocyte ratio as a method of predicting complications following hepatic resection for colorectal liver metastasis

“…A body of work has shown that CRP can predict the severity of complications following abdominal surgery, and we hope that the NLR can be used in a similar vein. [21][22][23][24] Furthermore, we have shown that it discriminates major complications with a higher sensitivity and specificity than total WCC differential and CRP, perhaps the two most widely considered parameters by surgeons in the post-operative period.…”

Serum procalcitonin as an early diagnostic marker of severe postoperative complications after elective pancreaticoduodenectomy

“…18,19 Furthermore, the correlation between pancreatic surgery, with or without postoperative complications, and the reactance of PCT elevation has not been fully elucidated. 20,21 The aim of the present study was to evaluate the clinical utility of postoperative PCT levels after PD as a potential early diagnostic biomarker for severe postoperative life-threatening complications.…”