Background: 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).
Methods: 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.
Results: 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).
Conclusion: 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.
Keywords: Leukocytosis; Pancreatectomy; Pancreatic fistula; Splenectomy; Surgical wound infection.
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