Accessible Unlicensed Requires Authentication Published by De Gruyter April 12, 2018

Serum procalcitonin concentration within 2 days postoperatively accurately predicts outcome after liver resection

Yuto Aoki ORCID logo, Nobuhiko Taniai, Masato Yoshioka, Youichi Kawano, Tetsuya Shimizu, Tomohiro Kanda, Ryota Kondo, Yohei Kaneya, Hiroyasu Furuki and Eiji Uchida



Relatively high mortality and morbidity rates are reported after liver resection (LR). However, the early predictors of complications after LR are not clear. This study was performed to clarify the usefulness of procalcitonin (PCT) for the early prediction of complications after elective LR.


This observational study included 72 consecutive patients who underwent elective LR from December 2015 to March 2017. Patients were categorized into two groups: those with and without postoperative complications (Clavien-Dindo grade ≥II). The values of postoperative inflammatory markers (white blood cell [WBC] count, C-reactive protein [CRP] and PCT) were compared between the two groups.


CRP and PCT were significantly higher in patients with than without complications; however, the WBC count showed no difference within 5 days postoperatively. The maximum area under the receiver operating characteristic curves within 2 days after LR using the WBC count, CRP and PCT were 0.608, 0.697 and 0.860, respectively, PCT had the best predictive ability in the early postoperative period. The PCT level peaked within 2 days postoperatively in 61 patients (85%). The maximum PCT level within 2 days postoperatively (PCT1−2) was significantly higher in patients with than without complications (0.52 vs. 0.19 ng/mL, p<0.001). A cutoff PCT1−2 level of 0.35 ng/mL achieved 80% sensitivity and 83% specificity. In patients without complications, there was no difference in PCT1−2 even when the surgical procedure differed (p=0.935).


PCT1−2 is an early predictive marker after LR and can be similarly used regardless of the LR procedure.

Corresponding author: Yuto Aoki, MD, PhD, Department of Gastrointestinal and Hepato-Biliary-Pancreatic Surgery, Nippon Medical School, 1-1-5 Sendagi, Bunkyo-ku, Tokyo 113-8603, Japan, Phone: +81-3-3822-2131, Fax: +81-3-5685-0989


We thank Angela Morben, DVM, ELS, from Edanz Group ( for editing a draft of this manuscript.

  1. Author contributions: YA – Study design, data collection, data analysis, writing first draft of manuscript, critical revisions, approved final version. NT – Study design, data analysis, approved final version. MY – Study design, data collection, data analysis, approved final version. YKaw – Study design, data analysis, approved final version. TS – Study design, data collection, data analysis, approved final version. TK – Data analysis, approved final version. RK – Study design, data collection, data analysis, approved final version. YKan – Study design, data collection, data analysis, approved final version. HF – Data analysis, approved final version. EU – Study design, critical revisions, approved final version. All the authors have accepted responsibility for the entire content of this submitted manuscript and approved submission.

  2. Research funding: Nobuhiko Taniai received grants from Teijin Pharma Limited for research for liver transplantation; these grants were outside the scope of this work.

  3. Employment or leadership: None declared.

  4. Honorarium: None declared.

  5. Competing interests: The funding organization(s) played no role in the study design; in the collection, analysis, and interpretation of data; in the writing of the report; or in the decision to submit the report for publication.


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Supplementary Material:

The online version of this article offers supplementary material (

Received: 2018-01-10
Accepted: 2018-02-27
Published Online: 2018-04-12
Published in Print: 2018-07-26

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