C-reactive protein postoperative values to predict clinically relevant postoperative pancreatic fistula after distal pancreatectomy.

Introduction Despite significant medical and technological advances, the incidence of Postoperative pancreatic fistula (POPF) after distal pancreatectomy (DP) is reported to be between 3-45%. The main objective of our study was to analyse the early post-surgical risk factors for developing POPF after DP. Material and methods A retrospective observational study was conducted on a prospective basis of patients undergoing PD in a tertiary hospital from January 2011 to December 2021. Sociodemographic, preoperative analytical, tumour-related and postoperative complications variables were analysed. Results Of the 52 patients analysed, 71.8% of the sample had postoperative drains amylase elevation; however, 25.7% of the total had Grade-B and/or Grade-C POPF. Univariate logistic regression with the variables studied showed the following as risk factors for B-C o clinically relevant POPF: amylase values in drainage at 5th POD [p=0.097; 1.01 (1-1.01)] preoperative BMI [p=0.015; 1.27 (1.04-1.55)] and CRP value at 3rd POD [p=0.034; 1.01 (1.01-1.02)]. The ROC curve of CRP value at 3rd POD showed an area under the curve 0,764 (CI 95% 0,6-0,93) and the best cut-off point was 190 mg/L (Sensitivity 89% and Specificity 67%). Conclusions CRP value at 3rd POD is a predictive factor for POPF after DP. Early detection of patients at risk for POPF based on these characteristics could have an impact on their postoperative management.