Early Prediction Of Procalcitonin,white Blood Cell Count,and C-reactive Protein For Postoperative Pancreatic Fistula

Objective:To evaluate the early predictive value of serum procalcitonin(PCT),C-reactive protein(CRP),and white blood cell count(WBC)levels for pancreatic fistula after pancreaticoduodenectomy(PD).Methods:Retrospective analysis of data of 93 patients undergoing PD treatment in pancreatic surgery at the First Affiliated Hospital of Xinjiang Medical University from January 2017 to November 2019,record the general information of patients before and postoperative pancreatic fistula,record the levels of serum PCT,CRP,and WBC before and 1st,3rd,and 5th days after operation,and divide them into pancreatic fistulas according to pancreatic fistula(63 cases)Compared with the non-pancreatic fistula group(30 cases),compare the preoperative data with the difference between the two groups,draw a box plot and the receiver operating characteristic curve(ROC),calculate the area under the ROC curve(AUC),and calculate PCT,CRP,WBC levels alone and jointly predict the sensitivity and specificity of pancreatic fistula.Results:There were no statistically significant differences in the age,gender,presence or absence of diabetes,total bilirubin,preoperative albumin,surgical time,and intraoperative bleeding in the general information of the pancreatic fistula group and the non-pancreatic fistula group.The difference in index(BMI)was statistically significant.Preoperative PCT,CRP,WBC and PCT on the first postoperative day were not statistically significant between the two groups(P=0.424,P=0.819,P=0.484,P=0.072),The PCT values on the 3rd and 5th days after surgery,the CRP and WBC values on the1 st,3rd,and 5th days after surgery were all statistically significant(all P values were<0.05).The area under the ROC curve was jointly predicted by the three at 5 days(AUC=0.792,0.812),and the sensitivity(62.9%,71.4%)and specificity(83.3%,80%)are better than the three alone.Conclusions:The PCT,CRP,and WBC values on the 1st,3rd,and 5th days after surgery alone have certain limitations in predicting pancreatic fistula,and the combined prediction of the three is more valuable.