Predictive value of procalcitonin for postoperative early pancreatic fistula
10.3760/cma.j.issn.1007-631X.2019.02.004
- VernacularTitle:降钙素原对胰十二指肠切除术后胰瘘早期预测的价值
- Author:
Guangzhou LI
1
;
Zongwen ZHU
;
Hongtao TAN
;
Dexing GUO
;
Zhongqiang ZUO
;
Bei SUN
;
Hongchi JIANG
Author Information
1. 哈尔滨医科大学附属第一医院胰胆外科 150001
- Keywords:
Pancreaticoduoden atectomy;
Pancreatic fistula;
Procalcitonin
- From:
Chinese Journal of General Surgery
2019;34(2):108-112
- CountryChina
- Language:Chinese
-
Abstract:
Objective To investigate the predictive value of PCT for postoperative pancreatic fistula (POPF) in advance.Methods Clinical data of 62 consecutive patients who underwent pancreaticoduodenectomy(PD) and 19 consecutive patients who underwent distal pancreatectomy (DP) between Apr 2016 and Apr 2017 in the First Affiliated Hospital of Harbin Medical University and met the inclusion criteria were retrospectively collected and analyzed.Patients with PD and DP were divided into pancreatic fistula group (12 cases,3 cases),and non-pancreatic fistula group (50 cases,16 case).The PCT,CRP and WBC count levels of preoperative and postoperative day 1,3,5 (POD1,POD3,POD5) were compared between two groups.The data were subjected to independent sample t-test,Mann-Whitney rank sum test,x2 test or Fisher exact test.Receiver operating characteristic (ROC) curve was drawn and area under curve (AUC) was calculated to determine the cutoff value,sensitivity and specificity.Results For PD and DP patients,there were no significant difference on age,gender,BMI,diabetes,obstructive jaundice,preoperative laboratory test,operation time,intraoperative blood loss,tumor type between the two groups,which were comparable.For PD patients,postoperative hyperglycemia rate,postoperative ICU admission rate and total hospital stay of pancreatic fistula group were significantly higher than those of non-pancreatic fistula group (P =0.011,P =0.023,P ＜0.001).The PCT levels of POD1,POD3 and POD5 of pancreatic fistula group were significantly higher than those of non-pancreatic fistula group (P ＜ 0.001,P =0.010,P =0.002).PCT of POD1 had the highest sensitivity (100％) and specificity (80％) and PCT ＞0.76 μg/L was the risk factor for POPF.For DP patients,the PCT levels of POD1,POD3 and POD5 had the same predictive value for pancreatic fistula.Conclusion PCT has early predictive value for POPF of PD patients.
