Laparoscopic sleeve gastrectomy: A role of inflammatory markers in the early detection of gastric leak.
C-reactive protein
gastric leak
laparoscopic sleeve gastrectomy
neutrophil-to-lymphocyte ratio
procalcitonin
Journal
Journal of minimal access surgery
ISSN: 0972-9941
Titre abrégé: J Minim Access Surg
Pays: India
ID NLM: 101228183
Informations de publication
Date de publication:
Historique:
pubmed:
24
9
2020
medline:
24
9
2020
entrez:
23
9
2020
Statut:
ppublish
Résumé
Laparoscopic sleeve gastrectomy (LSG) is gaining popularity as a bariatric option. Gastric leak (GL) is the most dreaded septic complication of LSG. Early detection and treatment of this complication may improve outcomes. This study investigates biomarkers that might be useful to predict GL before its clinical presentation in patients who underwent LSG. This study, prospective observational, was carried out in 151 patients, who underwent LSG for morbid obesity between February 2014 and October 2019. Blood samples were collected before the operation and on post-operative days one, three and five to dose serum C-reactive protein (CRP), pro-calcitonin (PCT), fibrinogen, white blood cells (WBCs) count and neutrophil-to-lymphocyte ratio (NLR). GL occurred in 6 patients (3.97%). According to the receiver operating characteristics curve, NLR detected leak with remarkably higher sensitivity (100%) and specificity (100%) than CRP, fibrinogen, WBC on all the days and higher than PCT in post-operative days 3 and 5. Moreover, the area under the curve (AUC) of NLR (AUC = 1) was higher than the AUC of CRP, fibrinogen, WBC on all the days and higher than PCT in post-operative days 3 and 5, suggesting important statistical significance. Because NLR and PCT detected GL with remarkably higher sensitivity and specificity than CRP, fibrinogen and WBC, these two markers seem to be more accurate for the early detection of this complication.
Identifiants
pubmed: 32964887
pii: 294958
doi: 10.4103/jmas.JMAS_3_20
pmc: PMC8270050
doi:
Types de publication
Journal Article
Langues
eng
Pagination
342-350Déclaration de conflit d'intérêts
None
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