Early postoperative serum IL-6 may contribute to risk stratification for pancreas-specific complications after pancreatic resection.

PURPOSE: IL-6 level in serum has been shown to have predictive value for postoperative infectious complications and prognostic value in acute pancreatitis. Evidence on its role after pancreatic resection is limited. The aim of the study was to analyse the predictive role of early postoperative serum IL-6 regarding complications after pancreatic resection. METHODS: A retrospective analysis of patients with pancreatic resection at a tertiary German centre was performed. All IL-6 values per patient within 48 h after resection were delineated. Values at fixed postoperative time points were interpolated between each patient's measurements and, beyond them, predicted from a linear mixed-effects model. Receiver operating characteristic curve analysis was performed, and optimal time and cut-off points for prediction of postoperative pancreatic fistula (POPF), postpancreatectomy acute pancreatitis (PPAP) and overall complications were set out. RESULTS: Out of 316 patients, 157 patients with more than one IL-6 value were included. IL-6 at 36 h after resection showed the best diagnostic performance for all three endpoints. For PPAP B/C, the AUC was 0.800 (95% CI 0.685-0.916) at a cut-off of 296 pg/ml (sensitivity 62%, specificity 80%, PPV 26%, NPV 95%), and for POPF B/C 0.715 (0.632-0.798) at 192 pg/ml (sensitivity 70%, specificity 59%, PPV 52%, NPV 76%). Discrimination for major complications (Clavien-Dindo ≥ 3b) was weaker, with an AUC of 0.636 (0.539-0.733) at 208 pg/ml (sensitivity 55%, specificity 62%, PPV 44%, NPV 73%). CONCLUSION: Serum IL-6 within 48 h after pancreatic resection could be useful in risk assessment for pancreas-specific complications.