Serum C-reactive protein level on first postoperative day can predict occurrence of postoperative pancreatic fistula after laparoscopic gastrectomy

Shinichiro Yamada; Shigehiko Yagi; Koichi Sato; Mikiya Shin’e; Akimasa Sakamoto; Daichi Utsunomiya; Shohei Okikawa; Norimasa Aibara; Miya Watanabe; Masayoshi Obatake; Riki Ono; Masahiko Fujii; Hiromi Otani; Hideki Kawasaki

doi:10.2152/jmi.66.285

Shinichiro Yamada, Shigehiko Yagi, Koichi Sato, Mikiya Shin’e, Akimasa Sakamoto, Daichi Utsunomiya, Shohei Okikawa, Norimasa Aibara, Miya Watanabe, Masayoshi Obatake, Riki Ono, Masahiko Fujii, Hiromi Otani, Hideki Kawasaki

Author information

Shinichiro Yamada
Departments of Gastrointestinal Surgery, Ehime Prefectural Central Hospital, Matsuyama, Japan
Department of Surgery, Tokushima University, Tokushima, Japan
Shigehiko Yagi
Departments of Gastrointestinal Surgery, Ehime Prefectural Central Hospital, Matsuyama, Japan
Koichi Sato
Departments of Gastrointestinal Surgery, Ehime Prefectural Central Hospital, Matsuyama, Japan
Mikiya Shin’e
Departments of Gastrointestinal Surgery, Ehime Prefectural Central Hospital, Matsuyama, Japan
Akimasa Sakamoto
Departments of Gastrointestinal Surgery, Ehime Prefectural Central Hospital, Matsuyama, Japan
Daichi Utsunomiya
Departments of Gastrointestinal Surgery, Ehime Prefectural Central Hospital, Matsuyama, Japan
Shohei Okikawa
Departments of Gastrointestinal Surgery, Ehime Prefectural Central Hospital, Matsuyama, Japan
Norimasa Aibara
Departments of Gastrointestinal Surgery, Ehime Prefectural Central Hospital, Matsuyama, Japan
Miya Watanabe
Departments of Gastrointestinal Surgery, Ehime Prefectural Central Hospital, Matsuyama, Japan
Masayoshi Obatake
Departments of Gastrointestinal Surgery, Ehime Prefectural Central Hospital, Matsuyama, Japan
Riki Ono
Departments of Gastrointestinal Surgery, Ehime Prefectural Central Hospital, Matsuyama, Japan
Masahiko Fujii
Hiromi Otani
Departments of Gastrointestinal Surgery, Ehime Prefectural Central Hospital, Matsuyama, Japan
Hideki Kawasaki
Departments of Gastrointestinal Surgery, Ehime Prefectural Central Hospital, Matsuyama, Japan

Keywords: laparoscopic gastrectomy, postoperative pancreatic fistula, C-reactive protein

JOURNAL FREE ACCESS

2019 Volume 66 Issue 3.4 Pages 285-288

DOI https://doi.org/10.2152/jmi.66.285

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Abstract

Purpose : Postoperative pancreatic fistula (POPF) is a serious complication after gastrectomy for gastric cancer. The purpose of this study is to identify the risk factor of POPF and evaluate C-reactive protein on postoperative day 1 (POD1) as the predictor for POPF after laparoscopic gastrectomy (LG). Methods : Between May 2013 and September 2016, 226 patients who underwent LG for gastric cancer were investigated. Patients were divided into 2 groups; POPF group (n = 17) and control group (n = 209). Clinicopathological factors were compared between 2 groups. Results : In POPF group, there are more male patients (p = 0.003) compared with control group. Preoperative factors, such as age, BMI, and prevalence of previous operation and comorbidity showed no significant difference between 2 groups. Regarding tumor factors and perioperative data such as blood loss and operative time, there were also no significant difference between 2 groups. POPF group showed longer postoperative hospital stay, and higher serum CRP level on POD1 (p < 0.0001). Multivariate analysis revealed that high CRP level on POD1 ( ≥ 3mg/dl) was independent risk factor of POPF. Conclusions : High serum CRP level on POD1 can predict the occurrence of POPF. J. Med. Invest. 66 : 285-288, August, 2019

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