Year 2023 / Volume 115 / Number 7
Original
C-reactive protein postoperative values to predict clinically relevant postoperative pancreatic fistula after distal pancreatectomy

362-367

DOI: 10.17235/reed.2022.8795/2022

Luz Divina Juez, Elena Payno, Irene de Vicente, Eduardo Lisa, José Manuel Molina, Eduardo Lobo Martínez, José María Fernández Cebrián, Alfonso Sanjuanbenito,

Abstract
Introduction: despite significant medical and technological advances, the incidence of postoperative pancreatic fistula (POPF) after distal pancreatectomy (DP) is reported to be between 3-45 %. The main objective of this study was to analyze the early post-surgical risk factors for developing POPF after DP. Material and methods: a retrospective observational study was performed on a prospective basis of patients undergoing DP in a tertiary hospital from January 2011 to December 2021. Sociodemographic, preoperative analytical, tumor-related and postoperative complications variables were analyzed. Results: of the 52 patients analyzed, 71.8 % of the sample had postoperative drains amylase elevation. However, 25.7 % of the total had grade-B and/or grade-C POPF. Univariate logistic regression with the variables studied showed the following as risk factors for B-C or clinically relevant POPF: amylase values in drainage at the 5th postoperative day (POD) (p = 0.097; 1.01 [1-1.01]), preoperative BMI (p = 0.015; 1.27 [1.04-1.55]) and C-reactive protein (CRP) value at the 3rd POD (p = 0.034; 1.01 [1.01-1.02]). The ROC curve of CRP value at the 3rd POD showed an area under the curve of 0.764 (95 % CI: 0.6-0.93) and the best cut-off point was 190 mg/l (sensitivity 89 % and specificity 67 %). Conclusions: CRP value at the 3rd POD is a predictive factor for POPF after DP. Early detection of patients at risk of POPF based on these characteristics could have an impact on their postoperative management.
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Juez L, Payno E, de Vicente I, Lisa E, Molina J, Lobo Martínez E, et all. C-reactive protein postoperative values to predict clinically relevant postoperative pancreatic fistula after distal pancreatectomy. 8795/2022


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Publication history

Received: 16/03/2022

Accepted: 20/06/2022

Online First: 24/06/2022

Published: 06/07/2023

Article revision time: 91 days

Article Online First time: 100 days

Article editing time: 477 days


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