Drainage fluid C-reactive protein and total Leucocytic count levels as early detectors of anastomotic leakage postgastrointestinal resection

Nabil, Ahmed; Saleh, Mona E.; Khalil, Ahmed H.; Heiba, Karim; Elshazly, Mostafa

doi:10.4103/ejs.ejs_128_19

Drainage fluid C-reactive protein and total Leucocytic count levels as early detectors of anastomotic leakage postgastrointestinal resection

Authors

Abstract

Aim
Anastomotic leakage (AL) following gastrointestinal resection is a complication associated with significant morbidity and mortality. C-reactive protein (CRP) is produced by the liver in response to inflammatory cytokines and is used as an indicator for postoperative complications. This study investigated the role of CRP and total leukocyte count (TLC) in blood and drainage fluid in the prediction of AL following gastrointestinal resection.
Patients and methods
Serum and drainage fluid CRP and TLC in blood and drainage fluid were measured on the first, third, and fifth postoperative days (PODs) in 96 patients who underwent gastrointestinal resection.
Results
CRP in the drainage fluid was significantly elevated in patients who developed AL compared with those who did not have leak on all PODs (=0.003, <0.001, and <0.001 on the first, third, and fifth days, respectively); however, serum CRP levels were not elevated significantly as a result of AL. We found a significant difference in the levels of the TLC in the first and third PODs and not in the level of TLC in the drain.
Conclusion
CRP in the drainage fluid was found to be a predictor of AL following gastrointestinal resection especially on the third and fifth PODs with cutoff values of 137.5 and 171.5 mg/l, respectively.

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