WHITE BLOOD-CELL COUNT, LEUKOCYTE ELASTASE ACTIVITY, AND SERUM CONCENTRATIONS OF INTERLEUKIN-6 AND C-REACTIVE PROTEIN AFTER OPEN APPENDECTOMY

Objective: To investigate the kinetics of interleukin-6 (IL-6), leucoc yte elastase complex (elastase), C-reactive protein (CRP), and total w hite blood cell count (WBC) after open appendicectomy. Design: Prospec tive study. Setting: Teaching hospital, Sweden. Subjects: 21 Patients with suspected acute appendicitis who underwent appendicectomy. Interv entions: Serum samples were taken preoperatively and postoperatively o n days 1, 2, 6, 10, and 30. Main outcome measures: Changes in IL-6, el astase, and CRP concentrations and WBC postoperatively, and their corr elation with complications. Results: The highest IL-6 concentrations a nd WBC were found preoperatively, while postoperatively elastase peake d on day 1, and CRP on day 2. One patient developed a suspected deep i nfection resulting in secondary peaks of IL-6, WBC, and CRP on day 6. Two patients with perforated appendicitis had high preoperative values of IL-6, elastase, and CRP. Conclusions: Concentrations of IL-6, elas tase, and CRP, and WBC increase after surgical trauma, and can remain high for up to 10 days. It is important to understand the postoperativ e kinetics for each test. Postoperative complications might best be de tected by measuring IL-6 and CRP concentrations, and WBC.