- •Retrospective evaluation of white blood cell count (WBC) to detect complications.
- •WBC ≥16 × 109/L on postoperative day (POD) 3 is associated with major morbidity.
- •WBC increase ≥9 × 109/L on POD 3 from baseline is associated with major morbidity.
- •Patients meeting these criteria should raise concern for postoperative complication.
The aim of this study was to analyze the associations between the degree of postoperative leukocytosis and major morbidity after elective distal pancreatectomy with splenectomy (DPS).
Retrospective review of patients undergoing DPS for pancreatic diseases (2013–2016). Receiver operating characteristic curves, Youden’s index, and area under the curve were used to identify ideal lab cut-off values and discriminatory ability of postoperative white blood cell count to detect complications.
158 patients underwent DPS. Median age was 57 years (range, 22–90) and 53% of patients were male. POD3 absolute WBC count ≥16 × 109/L or an increase in WBC count ≥9 × 109/L from preoperative baseline was associated with major morbidity after DPS (AUC 0.7 and 0.7, respectively).
Postoperative day three leukocytosis ≥16 × 109/L or an increase in WBC of ≥9 × 109/L from preoperative baseline should raise clinical awareness for major postoperative complication after DPS.
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Published online: December 05, 2019
Accepted: December 3, 2019
Received in revised form: November 25, 2019
Received: October 14, 2019
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