Increased plasma levels of IL-6 and IL-8 are associated with surgical site infection after pancreaticoduodenectomy.
OBJECTIVE
Cytokines and chemokines potentially modulate postoperative immune response. Association of circulating cytokines and chemokines with postoperative infectious complications after pancreaticoduodenectomy was evaluated.


METHODS
Plasma concentrations of interleukin (IL) 6, IL-10, IL-8, macrophage chemoattractant protein 1, heat shock protein 70, and amylase, as well as amylase levels in peritoneal exudative fluid, were measured perioperatively in 60 consecutive patients who underwent pancreaticoduodenectomy.


RESULTS
Of the 60 patients, 27 patients had surgical site infection (SSI), including peritoneal infection in all, intra-abdominal abscess in 14, and radiologically visualized pancreatic leakage in 6. Postoperative plasma levels of IL-6, IL-8, and macrophage chemoattractant protein 1, as well as peritoneal amylase levels, were significantly higher in patients with SSI than in those without SSI (P < 0.05). Nonpancreatic cancer as a histopathologic diagnosis, high pancreatic juice flow, and increased levels of IL-6 and IL-8 were independently associated with SSI (P < 0.05) in multiple logistic regression analysis. Plasma levels of IL-6 and IL-10 among patients with SSI were significantly higher in those with pancreatic leakage than in those without leakage.


CONCLUSIONS
These results suggest that, in addition to pancreatic exocrine function, IL-6 and IL-8 are associated with postoperative SSI, including pancreatic leakage after pancreaticoduodenectomy.
Department of General Surgery, Chiba University Graduate School of Medicine, Inohana, Chiba, Japan. kimura-f@faculty.chiba-u.jp
Fumio
F
Kimura
Hiroaki
H
Shimizu
Hiroyuki
H
Yoshidome
Masayuki
M
Ohtsuka
Atsushi
A
Kato
Hideyuki
H
Yoshitomi
Satoshi
S
Nozawa
Katsunori
K
Furukawa
Noboru
N
Mitsuhashi
Shigeaki
S
Sawada
Dan
D
Takeuchi
Satoshi
S
Ambiru
Masaru
M
Miyazaki
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D021441:Carcinoma, Pancreatic Ductal / Q000473:pathology / Q000601:surgery; D004386:Duodenum / Q000601:surgery*; D005260:Female; D006801:Humans; D015850:Interleukin-6 / Q000097:blood*; D016209:Interleukin-8 / Q000097:blood*; D008297:Male; D008875:Middle Aged; D009361:Neoplasm Invasiveness; D010180:Pancreatectomy / Q000009:adverse effects*; D010190:Pancreatic Neoplasms / Q000473:pathology / Q000601:surgery; D011183:Postoperative Complications / Q000276:immunology; D013530:Surgical Wound Infection / Q000453:epidemiology* / Q000276:immunology
D015850:Interleukin-6; D016209:Interleukin-8