|
KMID : 1188520150110020095
|
|
Korean Journal of Clinical Oncology
2015 Volume.11 No. 2 p.95 ~ p.100
|
|
|
Postoperative white blood cell counts change after pancreatoduodenectomy: Early sign for pancreatic fistula
|
|
Kim Dae-Hwan
Han Ho-Seong
Yoon Yoo-Seok
Cho Jai-Young
Choi Young-Rok
Jang Jae-Yool
Choi Han-Lim
|
|
|
Abstract
|
|
|
Purpose: Pancreatic surgery is challenging and associated with high morbidity. Therefore, it is important to detect it early before it becomes clinically apparent. The white blood cell (WBC) count useful as a predictive marker of postoperative pancreatic fistula. The aim of this study was to evaluate the diagnostic accuracy of WBC in predicting pancreatic fistula.
Methods: Between September 2003 and December 2013, 405 patients underwent elective pancreaticoduodenectomy or pylorus preserving pancreaticoduodenectomy for periampullary malignancy. Among them, 372 patients with no preoperative leukocytosis were enrolled in this study. The serum WBC count was monitored daily until postoperative day 8. The clinic and pathological data of these patients were analyzed by reviewing medical records retrospectively.
Results: Thirty patients (8%) developed pancreatic fistula grade B and C. The WBC count, measured every other day, was significantly higher every other day during the first 7 postoperative days in patients who developed pancreatic fistula grade B and C, compared with those patients who did not develop pancreatic fistula. The WBC count cutoff value of 13.07×109/L, 10.37×109/L on postoperative day 1,7 yielded a sensitivity of 57%, 70%, specificity of 53%, 67% for the detection of pancreatic fistula.
Conclusion: Patients with postoperative fistula grades B and C showed WBC counts that did not decrease on subsequent measurements during the early postoperative period. The measurement of WBC counts after pancreaticoduodenectomy can play a clinically important role in the early detection of pancreatic fistula development even from postoperative one day.
|
|
|
KEYWORD
|
|
|
Leukocytosis, White blood cell, Pancreatic fistula, Pancreaticoduodenectomy, Postoperative complications
|
|
|
FullTexts / Linksout information
|
|
|
|
|
|
Listed journal information
|
|
|
|