1. C-reactive protein identifies patients at risk of postpancreatectomy hemorrhage.
- Author
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Vilhav, C., Fagman, J. B., Holmberg, E., Naredi, P., and Engström, C.
- Subjects
C-reactive protein ,PANCREATECTOMY ,PANCREATICODUODENECTOMY ,PANCREATIC fistula ,BODY mass index ,ABDOMINAL surgery ,HEMORRHAGE - Abstract
Background: Postpancreatectomy hemorrhage grade C (PPH C) is a dreaded complication after pancreaticoduodenectomy (PD) with high mortality rate. Concurrent risk factors for PPH C have been difficult to recognize. Connection between postoperative pancreatic fistulas (POPF) and PPH C is well known, but POPF is often unknown prior to the PPH. The aim of this retrospective study was to define potential predictive factors for PPH C. Methods: Retrospectively, 517 patients who underwent PD between 2003 and 2018 were included in the study. Twenty-three patients with PPH C were identified, and a matched control group of 92 patients was randomly selected. Preoperative data (body mass index, cardiovascular disease, history of abdominal surgery, biliary stent, C-reactive protein (CRP), ASA-score), perioperative data (bleeding, pancreatic anastomosis, operation time), and postoperative data (CRP, drain amylase, POPF, biliary fistula) were analyzed as potential predictors of PPH C. Results: High postoperative CRP (median 140 mg/L on day 5 or 6) correlated with the development of PPH C (p < 0.05). Postoperative drain amylase levels were not clinically relevant for occurrence of PPH C. Grade C POPF or biliary leak was observed in the majority of the PPH C patients, but the leaking anastomoses were not detected before the bleeding started. Discussion: High postoperative CRP levels are related to an increased risk of PPH C. [ABSTRACT FROM AUTHOR] more...
- Published
- 2022
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