Clinical immunology
The reoperation for infective complications after major surgery of pancreas does not evoke additional cytokine response

Blood cytokines are accepted as semiquantitative markers of the operative tissue trauma and mediators of the host immune response. There is not enough data on the cytokine response following a secondary trauma in the same individual, as an early reoperation, which may influence the clinical course after surgical reintervention and predict the outcome. The reoperation, usually performed within the first week after primary surgery, is an additional burden for the immune system. The objective of this study was to evaluate how does the reoperation affect the level of serum blood cytokines. Does another rise of the proinflammatory or rather of the anti-inflammatory cytokines take place or is there a decrease as an effect of elimination of the source of local infection? Studies were carried out in 43 patients with pancreatic carcinoma before and after operation and reoperation. We measured serum levels of IL6, IL1ra and sTNFRI before and after first operations and after reoperations performed because of infective complications of the pancreatic cancer surgery. Although a high postoperative rise of serum IL-6, IL-1ra and sTNFRI levels in patients after pancreatectomy over the preoperative values was observed, there was no increase in cytokine concentration after re-operation performed because of infective complications. Albeit the serum cytokine levels are good markers of the immune reactivity of surgical patients to the first operative trauma and in certain cases early predictors of the postoperative infective complications, their diagnostic value after reoperations is questionable.