Serum procalcitonin concentration within 2 days postoperatively accurately predicts outcome after liver resection

Abstract

Introduction: Relatively high mortality and morbidity rates are reported after liver resection (LR). However, the early predictors of complications after LR are not clear. Serum procalcitonin (PCT) is reportedly useful for prediction of postoperative complications in various types of surgery. The purpose of this study was to clarify the usefulness of PCT for the early detection of postoperative complications after elective LR. Methods: This observational study included 72 consecutive patients who underwent elective LR from December 2015 to March 2017. Patients were categorized into two groups: those with and without postoperative complications. The values of postoperative inflammatory markers [white blood cell (WBC) count, C-reactive protein (CRP), and PCT] were compared between the two groups. Results: CRP and PCT were significantly higher in patients with than without complications; however, the WBC count showed no difference within 5 days postoperatively. The PCT level peaked within 2 days postoperatively in 61 patients (85%). The maximum PCT level within 2 days postoperatively (PCT1-2) was significantly higher in patients with than without complications (0.52 vs. 0.19 ng/ml, p < 0.001). A cut-off PCT1-2 level of 0.35 ng/ml achieved 80% sensitivity and 83% specificity. PCT1-2 was superior to CRP level within 2 days postoperatively (CRP1-2) for correct diagnosis of complications after LR (p = 0.006). In the patients without complications, there was no difference in PCT1-2, even if the surgical procedure was different (p = 0.935). Conclusions: PCT1-2 is an early prediction maker after LR and can be similarly used regardless of surgical procedure of LR.