Letter to the Editor
Copyright ©The Author(s) 2022. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastrointest Surg. Mar 27, 2022; 14(3): 268-270
Published online Mar 27, 2022. doi: 10.4240/wjgs.v14.i3.268
Is it sufficient to evaluate only preoperative systemic inflammatory biomarkers to predict postoperative complications after pancreaticoduodenectomy?
Semra Demirli Atici, Erdinc Kamer
Semra Demirli Atici, Erdinc Kamer, Department of General Surgery, University of Health Sciences Tepecik Training and Research Hospital, İzmir 35180, Turkey
Author contributions: Demirli Atici S and Kamer E wrote the manuscript; Kamer E reviewed and supervised the manuscript preparation; Both authors read and agreed to the published version of the manuscript.
Conflict-of-interest statement: The authors declare having no potential conflicts of interest with respect to the research, authorship and/or publication of this article.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Semra Demirli Atici, MD, Surgeon, Department of General Surgery, University of Health Sciences Tepecik Training and Research Hospital, Güney Mahallesi, 1140/1 Sokak No. 1 Yenişehir/Konak, İzmir 35180, Turkey. smrdemirli@hotmail.com
Received: November 21, 2021
Peer-review started: November 21, 2021
First decision: December 27, 2021
Revised: January 7, 2022
Accepted: March 6, 2022
Article in press: March 6, 2022
Published online: March 27, 2022
Processing time: 124 Days and 8.3 Hours

Postoperative morbidity and mortality rates are still very high among patients undergoing pancreaticoduodenectomy (PD). However, mortality rates secondary to morbidities that are detected early and well-managed postoperatively are lower among patients undergoing PD. Since early detection of complications plays a very important role in the management of these patients, many ongoing studies are being conducted on this subject. Recent endoscopic retrograde cholangiopancreatography and biliary drainage history of the patient study group is important for comparison of C-reactive protein (CRP), an inflammatory parameter evaluated in the retrospective study by Coppola et al published in the World Journal of Gastrointestinal Surgery and titled “Utility of preoperative systemic inflammatory biomarkers in predicting postoperative complications after pancreaticoduodenectomy: Literature review and single center experience”. Therefore, it may be more appropriate to compare CRP values in randomized patients.

Keywords: Pancreaticoduodenectomy, Biliary drainage, Complications, C-reactive protein, CRP, Postoperative pancreatic fistula, Preoperative inflammatory markers

Core Tip: Predicting the complications that may develop after pancreaticoduodenectomy is very important in the management of patients. Preoperative and intraoperative scoring of patients with the combination of many parameters, such as pancreatic structure, pancreatic duct diameter, preoperative biliary drainage history and laboratory parameters, can guide the estimation of postoperative morbidity and management. Inflammatory biomarkers are easily affected by preoperative treatment. In order to discuss such situations, we think that it would be more appropriate to prospectively randomize patients in whom dynamic changes of inflammatory parameters can be observed with reported risk factors, including not only C-reactive protein value but also other inflammatory parameters, rather than these preoperative values.