Clinical evaluation of C-reactive protein and procalcitonin for the early detection of postoperative complications after laparoscopic sleeve gastrectomy.

Abstract

IntroductionAmong the most common early complications after bariatric surgery are anastomosis leak and bleeding. In order to react quickly and perform accurate treatment before the clinical signs appear, early predictors should be found. In the study C-reactive protein (CRP) and procalcitonin (PCT) levels were investigated. Characterized by a relatively short half-life, they can predict surgical complications.AimTo develop and implement certain standards for early detection of complications.Material and methodsThe study involved 319 adults who underwent laparoscopic sleeve gastrectomy (LSG) as a surgical intervention for morbid obesity at the Department of General Surgery of Ceynowa Hospital in Wejherowo. Every patient had CRP and PCT levels measured before the surgery and on the 1st and 2nd postoperative day (POD).ResultsEarly postoperative complications occurred in 19 (5.96%) patients. Septic and non-septic complications occurred in 3 and 16 patients respectively. Among the patients with septic postoperative complications CRP level increased significantly on the 2nd POD compared to the remainder (p = 0.0221). Among the patients with non-septic postoperative complications CRP level increased significantly on the 1st and 2nd POD compared to the remainder. Among the patients with septic and non-septic postoperative complications PCT level increased significantly on the 2nd POD compared to the remainder.ConclusionsThe CRP and PCT level are supposed to be relevant diagnostic markers to predict non-septic and septic complications after LSG.

Applicability of common inflammatory markers in diagnosing infections in early period after liver transplantation in intensive care setting

“…Procalcitonin may, however, be used to predict development of severe postoperative complications considering remarkable differences observed as early as on the first postoperative measurement, performed within first 12 postoperative hours. This confirms previous findings from non-transplant setting for the field of liver transplantation [33][34][35] . Nevertheless, these differences also seem to derive from perioperative factors influencing its postoperative changes, such as the need for intraoperative dialysis or transfusion requirement, as they indicate altered course of the transplantation or more severely ill recipient.…”

Gender-related metabolic outcomes of laparoscopic sleeve gastrectomy in 6-month follow-up.

“…A strong correlation was demonstrated in obese patients between C-reactive protein concentration in serum and BMI, and furthermore, body mass loss causes CRP decrease [33][34][35]. Moreover, a rapid increase of CRP in the early postoperative period is a marker of complications after LSG [36]. In our examined group, the concentration of CRP did not exceed laboratory norms in any observation period.…”

Laparoscopic sleeve gastrectomy: a study of efficiency in treatment of metabolic syndrome components, comorbidities and influence on certain biochemical markers.

“…Other authors provide information that the overall long-term (above > 12 months) influence of bariatric treatment on kidney, liver and inflammatory function is positive, so these results could be considered as a good prognostic factor also in our assessment [39][40][41][42]. C-reactive protein and other inflammatory marker levels' postoperative increase is also proven to be diagnostic in operation technique related complications, such as bleeding or anastomosis leak [43], but the patients who developed such complications were excluded from the follow-up, and therefore mentioned conclusions on the postoperative inflammatory function could be stated. Worth emphasizing is that there are many other factors influencing overall postoperative outcome, that are not connected with operative technique.…”