Predictive Value of C-Reactive Protein for Complications Post-Laparoscopic Roux-en-Y Gastric Bypass

Excerpt

Gastric bypass and laparoscopic sleeve gastrectomies are standardized procedures [1]. The occurrence of fistula after bariatric surgery is unpredictable and the etiology is unknown. Early detection of these complications helps to lower the mortality and morbidity rate after bariatric surgery. Williams MR et al. concluded that “CRP on POD 2 has been shown to be a good predictor of both minor and major complications and can therefore be used to guide clinicians in making decision as to which patients may need further investigation or who can be safely discharged” [2]. We agree with Williams MR that the C-reactive protein (CRP) has high sensitivity but low specificity as a diagnostic indicator of sepsis. CRP serves as one of the most important inflammatory marker in many chronic diseases, including chronic kidney disease, diabetes, and major cardiovascular diseases. CRP is rapidly synthesized by the liver in response to infection, inflammation, and tissue damage. The circulating CRP is synthesized and secreted predominantly by hepatocytes in response to proinflammatory cytokines such as tumor necrosis factor α (TNF-α), interleukin-1 (IL-1), and interleukin-6 (IL-6). It plays an important role in innate immunity, opsonization by its properties, complement activation and immunoglobulins receptor binding. CRP is a protein of the acute systemic inflammation and is, therefore, a prime marker of inflammation. …