Abstract
Anastomotic leakage (AL) is the most drastic complication specific to intestinal surgery, but it is frequently diagnosed late. Early diagnosis and prompt treatment can reduce morbidity and mortality. The aim of the study was to evaluate the diagnostic accuracy of serial C – reactive protein (CRP) in early detection of anastomotic leakage in routine abdominal procedures. The study was conducted over a period of 1 year from 1 st January 2015 to 31th December 2015 in the Department of Surgery of DMCH. Within the period, 100 patients were prospectively selected for the study irrespective of age and sex. CRP of all patients was measured on 3rd and 5thpost operative day (POD). Data was collected through questionnaire. 27 patients had anastomotic leakage. Mean age of the leakage and non leakage were 44.77 ± 15.00 and 48.09 ± 13.68 years respectably (p = 0.308). There was male predominance in both the groups.Most (55%) of the anastomotic leakage (AL) occurred in the pancreaticojejunostomy patients. In 3rdpost operative day (POD) the mean ± SD CRP with the anastomotic leakage (AL)group and non-anastomotic leakage(non AL)group were 180.88±61.63 and 96.65±44.76 (p<.0001). In 5 th post operative day (POD) the mean CRP of anastomotic leakage(AL) and non anastomotic leakage (non-AL) were consecutively 121.18±33.64 and 45.60±28.71 (p<.0001). Cutoff value for CRP of 143 mg/l on POD 3 was associated with development of anastomotic leakage (AL). Patients with CRP levels at or below 143 mg/l on POD 3 can be safely discharged after elective abdominal surgery
Published Version
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