Serum Procalcitonin as an Early Predictor of Postoperative Complications Following Liver Resection: A Prospective Observational Study

Postoperative complications (POC) following liver resection (LR) can significantly affect patient outcomes, and early predictors are crucial for timely intervention, particularly in resource-limited settings such as Bangladesh. In this prospective observational study conducted from August 2021 to July 2022, 42 patients undergoing LR were enrolled and divided into two groups based on the presence (n = 22) or absence (n = 20) of POC. Serum procalcitonin (PCT), white blood cell count (WBC), and C-reactive protein (CRP) were measured on the first, third, and seventh postoperative days (POD). Mean serum PCT levels were significantly higher in patients with POC on all PODs (first POD: 2.508 vs. 0.898 µg/L, p = 0.011; third POD: 0.890 vs. 0.314 µg/L, p = 0.002; seventh POD: 0.611 vs. 0.181 µg/L, p = 0.005), whereas WBC and CRP did not differ between groups. The area under the receiver operating characteristic curve (AUC) for serum PCT was 0.798, 0.797, and 0.769 on the first, third, and seventh POD, respectively, indicating that first POD PCT is a reliable early predictor of POC. A cutoff value of 1.100 µg/L achieved 86.4% sensitivity and 70% specificity. These findings suggest that serum PCT on the first POD is a promising biomarker for early detection of postoperative complications after liver resection.