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Obesity Surgery

, Volume 19, Issue 7, pp 867–872 | Cite as

Early Identification of Infectious Complications in Bariatric Surgery by the Determination of Peritoneal and Systemic Cytokines

  • Wilson SalgadoJr
  • Fernando de Queiroz Cunha
  • José Sebastião dos Santos
  • Carla Barbosa Nonino-Borges
  • Ajith Kumar Sankarankutty
  • Orlando de Castro e SilvaJr
  • Reginaldo Ceneviva
Clinical Research

Abstract

Background

Obesity has become a global epidemic and bariatric surgery is one of the therapeutic tools to deal with it. Postoperative complications can occur, such as staple line dehiscence and anastomotic leaks, leading to increased patient mortality. The diagnosis of these complications is frequently difficult. The objective of the present study was to determine whether peritoneal and systemic cytokines could early detect those complications.

Methods

All patients who underwent open Roux-en-Y gastric bypass from February 2007 to August 2008 were prospectively evaluated. Blood and peritoneal effluent from the drain were collected for the determination of cytokine levels. We also evaluated the clinical signs and the leukograms of the patients.

Results

A total of 107 obese patients were studied. Ninety patients had no complications; 17 had at least one infectious complication which include five cases of staple line dehiscence. Until the third postoperative day, the vital signs and the leukogram did not predict the onset of infectious complications, but the cytokines (interleukin-1β and interleukin-6) were early markers of these complications.

Conclusion

Cytokines are good predictors of poor postoperative evolution in bariatric surgery since peritoneal cytokines diagnose better these infectious complications even before changes in blood count and before the occurrence of clinical manifestations.

Keywords

Cytokines Bariatric surgery Complications Staple line dehiscence Inflammatory response 

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Copyright information

© Springer Science + Business Media, LLC 2009

Authors and Affiliations

  • Wilson SalgadoJr
    • 1
  • Fernando de Queiroz Cunha
    • 2
  • José Sebastião dos Santos
    • 1
  • Carla Barbosa Nonino-Borges
    • 3
  • Ajith Kumar Sankarankutty
    • 1
  • Orlando de Castro e SilvaJr
    • 1
  • Reginaldo Ceneviva
    • 1
  1. 1.Department of Surgery and AnatomyMedical School of Ribeirão Preto of the University of São PauloRibeirão PretoBrazil
  2. 2.Department of PharmacologyMedical School of Ribeirão Preto of the University of São PauloRibeirão PretoBrazil
  3. 3.Department of Internal Medicine, Nutrology DivisionMedical School of Ribeirão Preto of the University of São PauloRibeirão PretoBrazil

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