A prospective study on the predictive value of procalcitonin for postoperative complications after pancreaticoduodenectomy

Objective To investigate the utility of plasma procalcitonin (PCT) as an early predictor for postoperative complications in patients who underwent elective pancreaticoduodenectomy (PD). Methods Clinical data of 87 patients who underwent elective PD in Changhai Hospital from March.1, 2016 to Dec.31, 2016 were collected. The general data, postoperative recovery, serum PCT level and white blood cell (WBC) count before, 1 d, 3 d and 5 d after PD were recorded. ROC curve was drawn and AUC was calculated to determine the cutoff value, sensitivity and specificity. Patients were divided into complication group (n=42) and noncomplication group (n=45) based on the occurrence of post-operative complications, and the comparisons between the two groups were performed. Results There were no significant differences on the age, gender, diabetes, obstructive jaundice, laboratory tests including PCT, operative time, blood loss volume during surgery and tumor type between the two groups, which were comparable. Complication group had longer hospitalization than noncomplication group (24 d vs 15 d, P 0.05), but the plasma PCT level in patients with pancreatic fistula and peritoneal infection on 3 d and 5 d after PD was significantly higher than those in noncomplication group, and the difference was statistically significant (all P<0.05). The combination of plasma PCT and WBC on 3 d and 5 d after PD was superior to PCT or WBC alone in predicting pancreatic fistula (sensitivity 88.9%, 72.7%; specificity 68.5%, 78.2%) and abdominal infection (sensitivity 100%, 100%; specificity 45.9%, 44.4%). Conclusions Plasma PCT could predict the occurrence of abdominal infection and pancreatic fistula after PD. The combination of PCT and WBC might be more valuable in predicting abdominal infection and pancreatic fistula. Key words: Pancreaticoduodenectomy; Procalcitonin; Postoperative complications; Abdominal infection; Pancreatic fistula