Gao XX, Su SH, Huang DD. Dynamic ultrasound monitoring of intraperitoneal effusion for predicting complications after laparoscopic gastrectomy. World J Gastrointest Surg 2026; 18(1): 113894 [DOI: 10.4240/wjgs.v18.i1.113894]
Corresponding Author of This Article
Xing-Xing Gao, MD, Department of Ultrasound, Shangrao Municipal Hospital, No. 182 Wusan Avenue, Shangrao 334000, Jiangxi Province, China. 18907033869@163.com
Research Domain of This Article
Gastroenterology & Hepatology
Article-Type of This Article
Retrospective Study
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
World J Gastrointest Surg. Jan 27, 2026; 18(1): 113894 Published online Jan 27, 2026. doi: 10.4240/wjgs.v18.i1.113894
Dynamic ultrasound monitoring of intraperitoneal effusion for predicting complications after laparoscopic gastrectomy
Xing-Xing Gao, Sheng-Hui Su, Dan-Dan Huang
Xing-Xing Gao, Department of Ultrasound, Shangrao Municipal Hospital, Shangrao 334000, Jiangxi Province, China
Sheng-Hui Su, Department of Ultrasound Medicine, Shangrao Municipal Hospital, Shangrao 334000, Jiangxi Province, China
Dan-Dan Huang, Physical Examination Center, Shangrao Municipal Hospital, Shangrao 334000, Jiangxi Province, China
Author contributions: Gao XX was responsible for the overall research design; Gao XX and Su SH provided support in experimental design, offering technical assistance; Su SH and Huang DD guided the overall direction of the study and revisions of the manuscript; Gao XX, Su SH, and Huang DD contributed to data collection and analysis, discussion of results; experiment implementation, and manuscript writing. All authors have read and approved the final manuscript.
Institutional review board statement: This study has been approved for review by the Ethics Committee of Shangrao Municipal Hospital.
Informed consent statement: All study participants, or their legal guardian, provided informed written consent prior to study enrollment.
Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.
Data sharing statement: No additional data are available.
Open Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Xing-Xing Gao, MD, Department of Ultrasound, Shangrao Municipal Hospital, No. 182 Wusan Avenue, Shangrao 334000, Jiangxi Province, China. 18907033869@163.com
Received: September 28, 2025 Revised: October 28, 2025 Accepted: December 3, 2025 Published online: January 27, 2026 Processing time: 115 Days and 1.5 Hours
Abstract
BACKGROUND
Transabdominal ultrasound monitoring can predict the occurrence of intraperitoneal effusion after laparoscopic gastrectomy and provide data reference for early intervention for postoperative complications.
AIM
To investigate dynamic monitoring of intraperitoneal effusion after laparoscopic gastrectomy and correlation with prognosis to guide intervention for postoperative complications.
METHODS
Eighty patients who underwent laparoscopic gastric cancer surgery in a general surgery department over four years was selected. Standardized transabdominal ultrasonography was performed on 1st, 3rd and 7th day after surgery. The incidence and nature of the effusion and inflammatory indicators were measured simultaneously. Intraperitoneal effusion risk was analyzed using the generalized estimating equation, linear mixed model was used to evaluate the factors influencing effusion collection, and Cox regression and receiver operating characteristic curves were used to evaluate the effectiveness of complication prediction.
RESULTS
The incidence of intraperitoneal effusion peaked on the 3rd postoperative day (52.50%, 42/80). Subgroup analysis showed a higher risk of fluid accumulation after total gastrectomy. The risk of intraperitoneal effusion after total gastrectomy was 2.10 times that of distal gastrectomy [odds ratio = 2.10, 95% confidence interval (CI): 1.14-3.87] and the risk of diabetes mellitus was increased by 85% (odds ratio = 1.85, 95%CI: 1.04-3.31). The complication risk of mixed effusion increased 3.86 times (hazard ratio = 3.86, 95%CI: 1.62-9.18), and the total complication rate reached 53.57% (15/28). Procalcitonin > 0.47 ng/mL on day 3 was the best predictor of infectious complications (area under the curve = 0.874, sensitivity: 82.9%, specificity: 81.7%), followed by C-reactive protein > 48.5 mg/L (area under the curve = 0.852). There was no significant difference in outcomes between the age subgroups.
CONCLUSION
Transabdominal ultrasonography accurately captures the evolution of effusion after laparoscopic gastrectomy. It is recommended that high-risk patients undergo focused ultrasonographic at 72 hours postoperatively to facilitate early intervention.
Core Tip: Dynamic transabdominal ultrasound monitoring provides an effective, noninvasive approach to assess the evolution of intraperitoneal effusion after laparoscopic gastrectomy. This study demonstrates that ultrasound-detected mixed effusion and elevated inflammatory markers, particularly procalcitonin on postoperative day 3, are strong predictors of infectious complications. Focused ultrasonography within 72 hours after surgery allows for timely detection and intervention, improving prognosis and reducing postoperative morbidity. Incorporating routine ultrasound monitoring into perioperative management may optimize clinical decision-making and enhance recovery in gastric cancer surgery patients.
