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

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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.

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Authors and Affiliations

  1. Department of Surgery and Anatomy, Medical School of Ribeirão Preto of the University of São Paulo, R. Antônio Chiericato, 760, Ribeirão Preto, SP, Brazil, Zip code 14096-510

    Wilson Salgado Jr, José Sebastião dos Santos, Ajith Kumar Sankarankutty, Orlando de Castro e Silva Jr & Reginaldo Ceneviva

  2. Department of Pharmacology, Medical School of Ribeirão Preto of the University of São Paulo, Ribeirão Preto, Brazil

    Fernando de Queiroz Cunha

  3. Department of Internal Medicine, Nutrology Division, Medical School of Ribeirão Preto of the University of São Paulo, Ribeirão Preto, Brazil

    Carla Barbosa Nonino-Borges

Authors
  1. Wilson Salgado Jr
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  2. Fernando de Queiroz Cunha
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  3. José Sebastião dos Santos
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  4. Carla Barbosa Nonino-Borges
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  5. Ajith Kumar Sankarankutty
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  6. Orlando de Castro e Silva Jr
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  7. Reginaldo Ceneviva
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Corresponding author

Correspondence to Wilson Salgado Jr.

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Salgado, W., de Queiroz Cunha, F., dos Santos, J.S. et al. Early Identification of Infectious Complications in Bariatric Surgery by the Determination of Peritoneal and Systemic Cytokines. OBES SURG 19, 867–872 (2009). https://doi.org/10.1007/s11695-009-9851-5

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  • DOI: https://doi.org/10.1007/s11695-009-9851-5

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