Predictive Value of Presepsin in Determining Leaks After Laparoscopic Sleeve Gastrectomy: A Pilot Study

Abstract

Objectives: Laparoscopic sleeve gastrectomy (LSG) is among the most effective surgical interventions in the long-term prevention of morbid obesity. Stapler line leaks and stapler line bleedings are important complications, which affect morbidity and mortality. The aim of this study is to determine the role of plasma presepsin levels for detection of stapler leaks. Methods: Sixty patients with LSG due to morbid obesity and 40 controls were included in this prospective study, which was carried out between April 2016 and July 2016 in our clinic. Patients were evaluated by a multidisciplinary team before surgery in accordance with the protocol of our hospital. Blood samples were obtained from patients without any medical treatment 12 hours before operation and 1st, 3rd, and 5th days postoperatively. Plasma presepsin levels, along with white blood counts (WBC, leukocyte), C-reaktive protein (CRP) and Neutrophil-Lymphocyte Ratio (NLR), were evaluated in patients who had sleeve gastrectomy line leakage. Results: In cases with complications, postoperative leukocyte count, CRP, NLR and presepsin measurements on the 1., 3. and 5. day were found higher than the group without complications. The predictive level of presepsin (p=0.006), CRP (p=0.023) and NLR (p=0.035) was found significantly higher than leukocyte (p<0.05). Conclusions: Our study indicates a role of presepsin levels in the detection and follow up of stapler line leaks following LSG. Increased levels of presepsin, especially on the first day of surgery, may play an important role for early detection of possible postoperative complications without clinical reflection.