Correlation of specific post-pancreatectomy morbidity and postoperative plasmatic biomarkers (BM) and inflammatory scores(IS)

Background: There are few reports evaluating changes of postoperative BM and IS (neutrophil-lymphocyte ratio NLR, platelet-lymphocyte rario PLR) associated with specific morbidity after pancreatic surgery. Methods: Prospective case-control study of major pancreatic resection (n=33) from Jan 2015 to Dec 2016. Specific complications (pancreatic fistula PF, delayed gastric emptying DGE, hemorraghe PH) and surgical site infection (SSI) were registered up. BM (lactate, reactive C protein) and IS were sistematically obtained on 1st, 2nd and 5th postoperative day (POD) and were compared between cases (patients with complications) and controls. Subgroup analysis of 24 pancreatoduodenectomy (PD). Results: Sex:60.6% males. Age:62±11 yo. DGE 31%, PF 24%, PH 21%, SSI 18%. PF associated with higher value of POD1-PLR (409.2 vs 208.9 p=0.034), POD2-lactate (1.6 vs 1.1 p=0.007), POD2-PLR (421.9 vs 229 p=0.02), POD2-RCP (335.2 vs 185.3 p=0.002). DGE associated with higher value of POD2-RCP (267 vs 165.7 p=0.001) SSI associated with higher value of POD2-NLR (15.9 vs 12.8 p=0.01). Whipple series: Similar results were obtained except for POD2-NLR (18.7 vs 12.1 p=0.029) and POD5-PLR (366 vs 205.3 p=0.005) higher value in patients with SSI. Conclusion: According to our results, there are some BM and IS which are associated to complications after major pancreatectomy, particularly higher POD2-lactate and POD2-RCP seem to be correlated to PF due to an hypothetical hipoxia in the anastomosis site. References [1] De Schryver N1, Wittebole X2, Hubert C3, Gigot JF4, Laterre PF5, Castanares-Zapatero D6., (2015), Early hyperlactatemia predicts pancreatic fistula after surgery., BMC Anesthesiol.