In open (emergency) and laparoscopic (elective) surgery; comparison of CK and CK-MB values in preoperative and postoperative periods

In general surgery clinics; Appendectomy and cholecystectomy operations are among the most frequently performed operations.CK and its isoenzyme CK-MB are among the blood parameters checked before and after these frequently performed operations. CK and CK-MB values are blood values that are not only measured in surgical patients but are commonly used in daily practice. These values are affected by many factors. Myocardial infarction (MI) is one of the leading causes of mortality today. Many parameters have been used for the diagnosis of this pathology from past to present, and studies in this area continue. Today, although it has left its place to troponin, CK-MB isoenzyme is still an important parameter used in the diagnosis of MI. CK and its isoenzyme CK-MB are affected by muscle damage. Especially, the postoperative elevation of CK-MB causes an incorrect pre-diagnosis of MI and causes unnecessary examinations, cardiology consultations, and effort.The national laboratory panic value system perceives this postoperative elevation of CK-MB as an abnormal condition, and a specific threshold value has not been determined for these patients. In a retrospective study on 5590 patients in Adıyaman Training and Research Hospital, it was observed that CK and CK-MB enzymes were increased in postoperative patients. This increase is directly proportional to the muscle damage in the surgical intervention. Since cholecystectomy cases were mostly closed, no significant increase in CK-MB was observed, since the muscle damage was small. Since appendectomy cases were performed with the open method, a significant increase in CK-MB was observed and this increase was 1.2 times on average. In this study, all patients had preoperative ECGs and no pathological findings were found in any of the patients. Cardiac pathology was not observed in any of the patients postoperatively. In conclusion, this study we have done is to help the Ministry of Health to revise the upper limit of CK-MB in laboratory panic values according to the patients who underwent surgery and to prevent unnecessary consultations.