{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,11,19]],"date-time":"2025-11-19T07:06:27Z","timestamp":1763535987207,"version":"3.37.3"},"reference-count":12,"publisher":"Wiley","issue":"6","license":[{"start":{"date-parts":[[2022,6,29]],"date-time":"2022-06-29T00:00:00Z","timestamp":1656460800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Journal of Surgical Oncology"],"published-print":{"date-parts":[[2022,11]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Early identification of complications after distal pancreatectomy splenectomy (DPS) poses challenges, as white blood cell count (WBC) is confounded by physiologic leukocytosis. We examined WBC patterns associated with complications after DPS.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Clinicopathologic data were collected for patients who underwent DPS in our system from 2009 to 2016. We examined WBC, temperature, platelet count (PC), and ratios of these variables as potential early indicators of patients at risk of infections or major complications (MCs).<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>348 patients met study inclusion, of whom 206 (59%) were women and the median patient age was 59\u2009\u00b1\u200915 years. Infectious and MC rates were 11% and 16%, respectively, with &lt;1% 30\u2010day mortality. Postoperative WBC peaks were higher in patients with infections and MCs compared with no complication (23 vs. 17, <jats:italic>p<\/jats:italic>\u2009&lt;\u20090.0001). WBC peak timing occurred postoperative day (POD) 2\u20133 for uncomplicated cases while peaks occurred POD9 for patients with infections and MCs.<\/jats:p><\/jats:sec><jats:sec><jats:title>Discussion<\/jats:title><jats:p>These data define patterns of leukocytosis following DPS. Although differences in infection markers were identified for patients with and without complications, no obvious thresholds were identified. Clinical suspicion for complications after DPS remains our best tool for early identification.<\/jats:p><\/jats:sec>","DOI":"10.1002\/jso.26988","type":"journal-article","created":{"date-parts":[[2022,6,29]],"date-time":"2022-06-29T08:02:52Z","timestamp":1656489772000},"page":"1012-1020","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Implications of leukocytosis following distal pancreatectomy splenectomy (DPS) and association with postoperative complications"],"prefix":"10.1002","volume":"126","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-8531-716X","authenticated-orcid":false,"given":"Jessica Y.","family":"Labib","sequence":"first","affiliation":[{"name":"Department of Surgery Emory University  Atlanta Georgia USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3770-2079","authenticated-orcid":false,"given":"Brendan P.","family":"Lovasik","sequence":"additional","affiliation":[{"name":"Department of Surgery Emory University  Atlanta Georgia USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Neha","family":"Lad","sequence":"additional","affiliation":[{"name":"Department of Transplant and HPB Surgery Case Western Reserve University  Cleveland Ohio USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0479-6344","authenticated-orcid":false,"given":"Julia","family":"Saltalamacchia","sequence":"additional","affiliation":[{"name":"Department of Surgery Oregon Health and Science University  Portland Oregon USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3591-8925","authenticated-orcid":false,"given":"Shishir K.","family":"Maithel","sequence":"additional","affiliation":[{"name":"Department of Surgical Oncology Emory University Winship Cancer Institute  Atlanta Georgia USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1874-6658","authenticated-orcid":false,"given":"Juan M.","family":"Sarmiento","sequence":"additional","affiliation":[{"name":"Department of Surgery Emory University  Atlanta Georgia USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Charles A.","family":"Staley","sequence":"additional","affiliation":[{"name":"Department of Surgical Oncology Emory University Winship Cancer Institute  Atlanta Georgia USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"John F.","family":"Sweeney","sequence":"additional","affiliation":[{"name":"Department of Surgery Emory University  Atlanta Georgia USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8694-0455","authenticated-orcid":false,"given":"David A.","family":"Kooby","sequence":"additional","affiliation":[{"name":"Department of Surgical Oncology Emory University Winship Cancer Institute  Atlanta Georgia USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2022,6,29]]},"reference":[{"key":"e_1_2_9_2_1","doi-asserted-by":"publisher","DOI":"10.1097\/SLA.0b013e318185a990"},{"key":"e_1_2_9_3_1","doi-asserted-by":"publisher","DOI":"10.1001\/archsurg.137.2.164"},{"key":"e_1_2_9_4_1","doi-asserted-by":"publisher","DOI":"10.1007\/s12262-013-1002-5"},{"key":"e_1_2_9_5_1","doi-asserted-by":"publisher","DOI":"10.5694\/mja11.10909"},{"key":"e_1_2_9_6_1","doi-asserted-by":"publisher","DOI":"10.1001\/archsurg.137.8.924"},{"key":"e_1_2_9_7_1","doi-asserted-by":"publisher","DOI":"10.1002\/bjs.1800780904"},{"key":"e_1_2_9_8_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1477-2574.2011.00369.x"},{"issue":"4","key":"e_1_2_9_9_1","article-title":"Leukocytosis after distal pancreatectomy with splenectomy: when should we be concerned? Scientific poster presentations: 2014 clinical Congress","volume":"219","author":"Neha L","year":"2014","journal-title":"J Am Coll Surg"},{"key":"e_1_2_9_10_1","doi-asserted-by":"publisher","DOI":"10.1097\/01.ta.0000189001.00670.d2"},{"issue":"7","key":"e_1_2_9_11_1","first-page":"387","article-title":"Postsplenectomy leukocytosis: physiologic or an indicator of infection?","volume":"58","author":"Horowitz J","year":"1992","journal-title":"Am Surg"},{"key":"e_1_2_9_12_1","doi-asserted-by":"publisher","DOI":"10.1097\/01.sla.0000133083.54934.ae"},{"key":"e_1_2_9_13_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.surg.2005.05.001"}],"container-title":["Journal of Surgical Oncology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/jso.26988","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1002\/jso.26988","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/jso.26988","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,8,21]],"date-time":"2023-08-21T08:11:26Z","timestamp":1692605486000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1002\/jso.26988"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,6,29]]},"references-count":12,"journal-issue":{"issue":"6","published-print":{"date-parts":[[2022,11]]}},"alternative-id":["10.1002\/jso.26988"],"URL":"https:\/\/doi.org\/10.1002\/jso.26988","archive":["Portico"],"relation":{},"ISSN":["0022-4790","1096-9098"],"issn-type":[{"type":"print","value":"0022-4790"},{"type":"electronic","value":"1096-9098"}],"subject":[],"published":{"date-parts":[[2022,6,29]]},"assertion":[{"value":"2022-01-17","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2022-06-11","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2022-06-29","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}