{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,23]],"date-time":"2026-10-23T20:53:28Z","timestamp":1792788808949,"version":"4.5.0"},"reference-count":28,"publisher":"Public Library of Science (PLoS)","issue":"9","license":[{"start":{"date-parts":[[2026,9,23]],"date-time":"2026-09-23T00:00:00Z","timestamp":1790121600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Bangladesh Medical University","award":["ANA 5458289"],"award-info":[{"award-number":["ANA 5458289"]}],"id":[{"id":"https:\/\/ror.org\/042mrsz23","id-type":"ROR","asserted-by":"crossref"}]}],"content-domain":{"domain":["www.plosone.org"],"crossmark-restriction":false},"short-container-title":["PLoS One"],"abstract":"<jats:p>Postoperative complications (POC) following liver resection (LR) can significantly affect patient outcomes, and early predictors are crucial for timely intervention, particularly in resource-limited settings such as Bangladesh. In this prospective observational study conducted from August 2021 to July 2022, 42 patients undergoing LR were enrolled and divided into two groups based on the presence (n\u2009=\u200922) or absence (n\u2009=\u200920) of POC. Serum procalcitonin (PCT), white blood cell count (WBC), and C-reactive protein (CRP) were measured on the first, third, and seventh postoperative days (POD). Median serum PCT levels were significantly higher in patients with POC on all PODs (POD1: 1.71 vs. 0.53 \u00b5g\/L, p\u2009=\u20090.001; POD3: 0.69 vs. 0.23 \u00b5g\/L, p\u2009=\u20090.001; POD7: 0.48 vs. 0.10 \u00b5g\/L, p\u2009=\u20090.003), whereas WBC and CRP did not differ between groups. The area under the receiver operating characteristic curve (AUC) for serum PCT was 0.798 (95% CI: 0.655\u20130.927), 0.797 (95% CI: 0.648\u20130.920), and 0.769 (95% CI: 0.614\u20130.898) on POD1, POD3, and POD7, respectively, indicating that POD1 serum PCT showed moderate discriminatory ability for the broad composite endpoint. Using the Youden index, the optimal POD1 serum PCT cutoff value was identified as 1.240 \u00b5g\/L, which achieved 86.4% sensitivity and 70.0% specificity. In exploratory multivariable analysis, higher POD1 serum PCT was associated with postoperative complications after adjustment for prespecified covariates (adjusted OR: 12.30; 95% CI: 1.44\u2013104.89; p\u2009=\u20090.022); however, the wide confidence interval and small number of events warrant cautious interpretation. Sensitivity analyses showed reduced discrimination for Clavien\u2013Dindo grade \u2265II (AUC: 0.650) and grade \u2265III complications (AUC: 0.581), indicating limited discriminatory ability for severe morbidity in this dataset. These findings suggest that POD1 PCT may support early postoperative risk stratification, but its clinical utility, particularly for severe morbidity, requires validation in larger studies.<\/jats:p>","DOI":"10.1371\/journal.pone.0338171","type":"journal-article","created":{"date-parts":[[2026,9,23]],"date-time":"2026-09-23T17:40:26Z","timestamp":1790185226000},"page":"e0338171","update-policy":"https:\/\/doi.org\/10.1371\/journal.pone.corrections_policy","source":"Crossref","is-referenced-by-count":0,"title":["Serum procalcitonin as an early marker associated with postoperative complications following liver resection: A prospective observational study"],"prefix":"10.1371","volume":"21","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-4681-7131","authenticated-orcid":true,"given":"Mohammad Saydul","family":"Aman","sequence":"first","affiliation":[{"name":"National Gastroliver Institute and Hospital","place":["Dhaka, Bangladesh"],"department":["Department of Surgical Gastroenterology"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Md. Shawkat","family":"Ali","sequence":"additional","affiliation":[{"name":"Rangpur Medical College Hospital","place":["Rangpur, Bangladesh"],"department":["Department of Surgery"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0004-8155-4212","authenticated-orcid":true,"given":"Bishow Raj","family":"Khadka","sequence":"additional","affiliation":[{"name":"Patan Academy of Health Sciences","place":["Lagankhel, Lalitpur, Bagmati, Nepal"],"department":["Department of General Surgery"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bineet Kumar","family":"Yadav","sequence":"additional","affiliation":[{"name":"Nobel Medical College Teaching Hospital Ltd.","place":["Morang, Nepal"],"department":["Department of General Surgery"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bidhan Chandra","family":"Das","sequence":"additional","affiliation":[{"name":"Pancreatic, and Liver Transplantation Surgery, Bangladesh Medical University","place":["Dhaka, Bangladesh"],"department":["Department of Hepatobiliary"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6601-5772","authenticated-orcid":true,"given":"Md Foyjul","family":"Islam","sequence":"additional","affiliation":[{"name":"Institute of Epidemiology Disease Control and Research (IEDCR)","place":["Dhaka, Bangladesh"],"department":["Department of Epidemiology"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"340","published-online":{"date-parts":[[2026,9,23]]},"reference":[{"issue":"49","key":"pone.0338171.ref001","doi-asserted-by":"crossref","DOI":"10.1097\/MD.0000000000005466","article-title":"Models predicting the risks of six life-threatening morbidities and bile leakage in 14,970 hepatectomy patients registered in the National Clinical Database of Japan","volume":"95","author":"H Yokoo","year":"2016","journal-title":"Medicine (Baltimore)"},{"issue":"11","key":"pone.0338171.ref002","doi-asserted-by":"crossref","DOI":"10.1371\/journal.pone.0241808","article-title":"A simple and clinically applicable model to predict liver-related morbidity after hepatic resection for hepatocellular carcinoma","volume":"15","author":"J Choi","year":"2020","journal-title":"PLoS One"},{"issue":"5","key":"pone.0338171.ref003","doi-asserted-by":"crossref","first-page":"645","DOI":"10.1016\/j.hpb.2020.12.009","article-title":"Predictors of complications after liver surgery: a systematic review of the literature","volume":"23","author":"G Longchamp","year":"2021","journal-title":"HPB (Oxford)"},{"issue":"7","key":"pone.0338171.ref004","doi-asserted-by":"crossref","first-page":"836","DOI":"10.1002\/bjs.9492","article-title":"Failure to rescue as a source of variation in hospital mortality after hepatic surgery","volume":"101","author":"G Spolverato","year":"2014","journal-title":"Br J Surg"},{"issue":"10","key":"pone.0338171.ref005","doi-asserted-by":"crossref","first-page":"919","DOI":"10.1111\/hpb.12469","article-title":"National trends with a laparoscopic liver resection: results from a population-based analysis","volume":"17","author":"J He","year":"2015","journal-title":"HPB (Oxford)"},{"issue":"6","key":"pone.0338171.ref006","first-page":"824","article-title":"The \u201c50-50 criteria\u201d on postoperative day 5: an accurate predictor of liver failure and death after hepatectomy","volume":"242","author":"S Balzan","year":"2005","journal-title":"Ann Surg"},{"key":"pone.0338171.ref007","doi-asserted-by":"crossref","first-page":"854","DOI":"10.1016\/j.jamcollsurg.2006.12.032","article-title":"Hepatic Insufficiency and Mortality in 1,059 Noncirrhotic Patients Undergoing Major Hepatectomy","volume":"204","author":"JT Mullen","year":"2007","journal-title":"J Am Coll Surg"},{"issue":"4","key":"pone.0338171.ref008","doi-asserted-by":"crossref","DOI":"10.1136\/bmjopen-2016-013966","article-title":"Is postoperative decrease of serum albumin an early predictor of complications after major abdominal surgery? 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