The Correlation between Serum Procalcitonin and C-Reactive Protein and Main Complications After Endoscopic Retrograde Cholangiopancreatography.

Background: The aim of this study was to explore the clinical value of serum procalcitonin (PCT) and C-reactive protein (CRP) levels in evaluating complications after endoscopic retrograde cholangiopancreatography (ERCP) in patients with common bile duct (CBD) stones.

Methods: Patients who were diagnosed with CBD stones and underwent ERCP from December 2021 to December 2023 were selected as the study subjects. According to whether postoperative complications occurred, they were divided into complication group (n = 28) and non-complication group (n = 132). The general clinical data, biochemical indexes, serum PCT, and CRP levels before ERCP and 4 hours and 24 hours after ERCP were compared. The changes of serum PCT and CRP levels in patients with different types of complications at 4 hours and 24 hours after ERCP were analyzed. The value of serum PCT, CRP levels, and combined indicators in distinguishing postoperative complications was analyzed.

Results: The proportion of previous pancreatitis and complications (hypertension and diabetes) in the complication group was higher than that in the non-complication group. Serum PCT and CRP levels of patients in the complication group were significantly higher than those in the non-complication group at 24 hours after ERCP (p < 0.001). Stratified according to the main types of complications, CRP level of patients with postoperative pancreatitis continued to increase at 4 hours and 24 hours after ERCP, while serum PCT increased only after 24 hours. When serum PCT and CRP levels were higher than 2.61 μg/mL and 68.18 mg/mL, respectively, at 24 hours after ERCP, the patients with postoperative complications could be well distinguished. The combination of the two indicators had a higher value in distinguishing patients with postoperative complications than the serum indicators alone.

Conclusions: The increase of serum PCT and CRP levels after ERCP is related to the complications after ERCP in patients with CBD stones. For patients with a high risk of complications after ERCP, the possibility of complications occurring can be evaluated by combined examination of serum PCT and CRP levels, and prevention and treatment measures can be taken as soon as possible.