Serum Procalcitonin as an Early Predictor of Postoperative Complications Following Liver Resection: A Prospective Observational Study

Abstract Postoperative complications (POC) following liver resection (LR) can significantly affect patient outcomes, and early predictors are crucial for timely intervention, particularly in resource-limited settings such as Bangladesh. In this prospective observational study conducted from August 2021 to July 2022, 42 patients undergoing LR were enrolled and divided into two groups based on the presence (n = 22) or absence (n = 20) of POC. Serum procalcitonin (PCT), white blood cell count (WBC), and C-reactive protein (CRP) were measured on the first, third, and seventh postoperative days (POD). Mean serum PCT levels were significantly higher in patients with POC on all PODs (first POD: 2.508 vs. 0.898 µg/L, p = 0.011; third POD: 0.890 vs. 0.314 µg/L, p = 0.002; seventh POD: 0.611 vs. 0.181 µg/L, p = 0.005), whereas WBC and CRP did not differ between groups. The area under the receiver operating characteristic curve (AUC) for serum PCT was 0.798, 0.797, and 0.769 on the first, third, and seventh POD, respectively, indicating that first POD PCT is a reliable early predictor of POC. A cutoff value of 1.100 µg/L achieved 86.4% sensitivity and 70% specificity. These findings suggest that serum PCT on the first POD is a promising biomarker for early detection of postoperative complications after liver resection. Competing Interest Statement The authors have declared no competing interest. Clinical Trial NA Funding Statement Yes Author Declarations I confirm all relevant ethical guidelines have been followed, and any necessary IRB and/or ethics committee approvals have been obtained. Yes The details of the IRB/oversight body that provided approval or exemption for the research described are given below: This study was conducted following approval from the Institutional Review Board of Bangladesh Medical University (Registration No. 3530). Written informed consent was obtained from all participants prior to their inclusion in the study. All procedures were performed in accordance with relevant guidelines and regulations, and participant confidentiality was strictly maintained. I confirm that all necessary patient/participant consent has been obtained and the appropriate institutional forms have been archived, and that any patient/participant/sample identifiers included were not known to anyone (e.g., hospital staff, patients or participants themselves) outside the research group so cannot be used to identify individuals. Yes I understand that all clinical trials and any other prospective interventional studies must be registered with an ICMJE-approved registry, such as ClinicalTrials.gov. I confirm that any such study reported in the manuscript has been registered and the trial registration ID is provided (note: if posting a prospective study registered retrospectively, please provide a statement in the trial ID field explaining why the study was not registered in advance). Yes I have followed all appropriate research reporting guidelines, such as any relevant EQUATOR Network research reporting checklist(s) and other pertinent material, if applicable. Yes Data Availability All of the data of the study was available on manuscript and its supplementary file.