Malya Fatma Umit, Hasbahceci Mustafa, Tasci Yunus, Kadioglu Huseyin, Guzel Mehmet, Karatepe Oguzhan, Dolay Kemal
Bezmialem Vakif University, Istanbul, Turkey.
Medical Park Fatih Hospital, General Surgery Clinic, Istanbul, Turkey.
Gastroenterol Res Pract. 2018 Jan 28;2018:9157806. doi: 10.1155/2018/9157806. eCollection 2018.
Despite recent advances in surgical techniques, pancreatic fistulas are common. We aimed to determine the role of C-reactive protein in the prediction of clinically relevant fistula development.
Data from patients who underwent pancreaticoduodenectomy between 2012 and 2015 is collected. Postoperative 1st, 3rd, and 5th day (POD1, POD3, and POD5) C-reactive protein (CRP) levels, postoperative pancreatic fistula (POPF) development, other complications, length of hospital stay, and mortality were recorded.
Of 117 patients, 43 patients (36.8%) developed complications (including fistulas). Of the patients developing fistulas, 21 (17.9%) had POPF A, 2 (1.7%) had POPF B, and 7 (6.0%) had POPF C. POD5 CRP and POD3 CRP were shown to be significantly correlated with mortality and development of clinically relevant POPF ( = 0.001 and = 0.0001, resp.) and with mortality ( = 0.017), respectively. The development of clinically relevant POPFs (B and C) could be predicted with 90% sensitivity and 82.2% specificity by POD5 CRP cut-off level of 19 mg/dL and with 100% sensitivity and 63.6% specificity by the difference between POD5 and POD1 CRP cut-off level of >2.5 mg/dL.
CRP levels can effectively predict the development of clinically relevant pancreatic fistulas.
尽管近期手术技术有所进步，但胰瘘仍很常见。我们旨在确定C反应蛋白在预测临床相关瘘管形成中的作用。
收集2012年至2015年间接受胰十二指肠切除术患者的数据。记录术后第1天、第3天和第5天（POD1、POD3和POD5）的C反应蛋白（CRP）水平、术后胰瘘（POPF）的发生情况、其他并发症、住院时间和死亡率。
117例患者中，43例（36.8%）出现并发症（包括瘘管）。在发生瘘管的患者中，21例（17.9%）为POPF A，2例（1.7%）为POPF B，7例（6.0%）为POPF C。结果显示，POD5 CRP和POD3 CRP分别与临床相关POPF的发生和死亡率显著相关（分别为 = 0.001和 = 0.0001）以及与死亡率相关（ = 0.017）。通过POD5 CRP临界值为19 mg/dL可预测临床相关POPF（B和C）的发生，敏感性为90%，特异性为82.2%；通过POD5与POD1 CRP临界值之差>2.5 mg/dL可预测，敏感性为100%，特异性为63.6%。
CRP水平可有效预测临床相关胰瘘的发生。
