CRP and neoplasm: Although patients who had a bile stent did not suffer from higher PI levels (compared with those without bile stent), bacterial overgrowth caused by the intervention maintains (chronic) inflammation, which on the one hand might not impair CRP and WBC levels but on the other hand hampers physical reserves and thus postoperative survival.46,47 However, despite the presence of PDAC-specific risk factors, progressive tumour mass (CA 19-9) as well as tumour stage, the PI is a reliable tool for preoperative survival prognostication in PDAC patients undergoing resection.