, Volume 17, Issue 4, pp 844-845
Date: 06 Dec 2012

C-Reactive Protein 2 Days After Laparoscopic Gastric Bypass Surgery Reliably Indicates Leaks and Moderately Predicts Morbidity

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To the Editor,

We read the article by Warschkow et al. reporting C-reactive protein (CRP) 2 days after laparoscopic gastric bypass surgery reliably indicates anastomotic leaks and moderately predicts morbidity with great interest.1 The authors are to be congratulated on the size of this cohort and their diligence in maintaining a prospective database. We would like to highlight a number of issues within this study. From a cohort of 809 patients, only 18.8 % had a CRP measured in the postoperative period. This may imply significant bias, as it is likely that CRP was only tested in those patients who had signs of complications. The reporting of significantly less complications in the group of 399 patients where CRP was not recorded supports this. Would CRP have predicted leak in this cohort? And what was the outcome for the 8.5 % of patients with complications in this group? To conclude that CRP on day 2 is an accurate predictor of outcome from a sample of 61 patients out of a possible 80