Evidence map›Paper›PMID 41654665›Full record

ArticleAnnals of surgical oncology2026

Evaluating C-Reactive Protein in Drainage Fluid as a Predictive Biomarker for Clinically Relevant Pancreatic Fistulas Following Pancreaticoduodenectomy.

Kenta Baba, Kenichiro Uemura, Tatsuaki Sumiyoshi, Ryuta Shintakuya, Kenjiro Okada, Takumi Harada, Shiro Oka, Yasutaka Ishii, Koji Arihiro, Yoshiaki Murakami and 1 more

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In one paragraph

Article in Annals of surgical oncology, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

11 authors.

Kenta BabaDepartment of Surgery, Graduate School of Biomedical and Health Science, Hiroshima University, Hiroshima, Japan.
Kenichiro UemuraDepartment of Surgery, Graduate School of Biomedical and Health Science, Hiroshima University, Hiroshima, Japan. umk@hiroshima-u.ac.jp.ORCID http://orcid.org/0000-0003-0003-6268
Tatsuaki SumiyoshiDepartment of Surgery, Graduate School of Biomedical and Health Science, Hiroshima University, Hiroshima, Japan.
Ryuta ShintakuyaDepartment of Surgery, Graduate School of Biomedical and Health Science, Hiroshima University, Hiroshima, Japan.
Kenjiro OkadaDepartment of Surgery, Graduate School of Biomedical and Health Science, Hiroshima University, Hiroshima, Japan.
Takumi HaradaDepartment of Surgery, Graduate School of Biomedical and Health Science, Hiroshima University, Hiroshima, Japan.
Shiro OkaDepartment of Gastroenterology, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan.
Yasutaka IshiiDepartment of Gastroenterology, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan.
Koji ArihiroDepartment of Anatomical Pathology, Hiroshima University Hospital, Hiroshima, Japan.
Yoshiaki MurakamiDigestive Disease Center, Hiroshima Memorial Hospital, Hiroshima, Japan.
Shinya TakahashiDepartment of Surgery, Graduate School of Biomedical and Health Science, Hiroshima University, Hiroshima, Japan.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundThis study was conducted to determine the use of C-reactive protein (CRP) levels in drainage fluid as an alternative indicator of clinically relevant postoperative pancreatic fistulas (CR-POPFs) following pancreaticoduodenectomy (PD). Reportedly, serum CRP levels are associated with CR-POPFs. Drainage fluid following PD is used to diagnose a pancreatic fistula, removing the need for blood sampling. However, the significance of CRP in drainage fluid remains unclear.

methodsIn this retrospective study, we reviewed consecutive patients who underwent PD at Hiroshima University between April 2014 and October 2021. Clinical factors for CR-POPFs were analyzed, and serum and drain CRP levels were measured during the first 4 days after surgery.

resultsAmong the 384 patients enrolled, 58 (15.1%) developed CR-POPFs. Serum and drain CRP levels on postoperative days (PODs) 2, 3, and 4 were significantly associated with CR-POPFs. Receiver operating characteristic analysis indicated that CRP levels on POD 4 most precisely predicted CR-POPFs, with area under the curve values of 0.820 and 0.803 for serum and drain CRP levels, respectively. Additionally, these two factors exhibited a strong positive correlation (p<0.001, r=0.814). Multivariate analysis revealed that drain CRP level ≥6.5 mg/dL on POD 4 independently predicted CR-POPFs (odds ratio 4.95; 95% confidence interval 2.27-10.81; p<0.001) with a negative predictive value of 95.6%.

conclusionsDrain CRP level on POD 4 is a strong predictive factor for CR-POPFs and may be an alternate criterion to serum CRP levels after PD.

Indexed as

C-Reactive ProteinDrainagePancreatic FistulaPancreatic NeoplasmsPancreaticoduodenectomyPostoperative ComplicationsAgedBiomarkersFemaleHumansMaleMiddle AgedPrognosisRetrospective StudiesBiomarkersC-Reactive ProteinC-reactive proteinDrainagePancreatectomyPancreatic fistulaPostoperative complications

Identifiers

PMID41654665
PMCPMC13179272

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.