Abstract
BackgroundHypoalbuminemia (HA) is a risk factor for the complications following pancreaticoduodenectomy (PD). This study aimed to explore the factors that affect HA following PD and evaluate the influence of HA on the short-term postoperative prognosis.Methods: Total 163 patients who underwent PD and met inclusion criteria were subdivided into two groups according to the status of HA. The relationships of postoperative albumin (ALB) level and exogenous ALB infusion with postoperative responses and complications were assessed by correlation analysis.ResultsPreoperative ALB ≥35.0 g/L and postoperative complication grade were factors influencing HA after PD. Correlation analysis demonstrated significant negative correlation of postoperative ALB level with white blood cell (WBC) count and neutrophil count. Postoperative exogenous ALB infusion positively correlated with blood urea nitrogen, creatinine, complication grade, postoperative intraperitoneal hemorrhage and pancreatic fistula. No significant differences were observed between the complications and30-day mortality rates with and without postoperative HA.ConclusionsHA after PD should not be considered as an indicator but rather a result of poor prognosis. WBCs, especially neutrophils, are involved in reducing postoperative ALB level. Infusion of exogenous ALB to maintain ALB > 30 g/L could not improve clinical outcomes.
Highlights
Hypoalbuminemia (HA) is a risk factor for the complications following pancreaticoduodenectomy (PD)
It is of great clinical significance to investigate the factors that influence postoperative HA and related complications in PD compared with other abdominal operations
According to classification based on the Clavien– Dindo criteria, the percentages of all patients who experienced grade I to grade V complications were grade I 22.1% (36/163), grade II 11.0% (18/163), grade IIIa 4.3% (7/ 163), grade IIIb 3.7% (6/163), grade IVa 1.2% (2/163), grade IVb 0% (0/163), and grade V 3.1% (5/163), respectively
Summary
Hypoalbuminemia (HA) is a risk factor for the complications following pancreaticoduodenectomy (PD). This study aimed to explore the factors that affect HA following PD and evaluate the influence of HA on the short-term postoperative prognosis. The relationships of postoperative albumin (ALB) level and exogenous ALB infusion with postoperative responses and complications were assessed by correlation analysis. Pancreaticoduodenectomy (PD) is a complicated abdominal surgical procedure and postoperative mortality for PD has decreased to 3–5% with improvements in the surgical technique and perioperative management [1,2,3]. Xu et al BMC Surgery (2020) 20:72 increase postoperative ALB level to a so-called “safe” range to improve patient condition. It is of great clinical significance to investigate the factors that influence postoperative HA and related complications in PD compared with other abdominal operations
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