Xu Wei, Peng Xiangqun, Jiang Bo
Department of Hepatobiliary Surgery, Hunan Provincial People's Hospital, The First Hospital Affiliated with Hunan Normal University, No. 61 West Jiefang Road, Changsha, 410005, China.
BMC Surg. 2020 Apr 15;20(1):72. doi: 10.1186/s12893-020-00739-2.
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.
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.
Preoperative 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.
HA 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.
低白蛋白血症(HA)是胰十二指肠切除术(PD)后并发症的一个危险因素。本研究旨在探讨影响PD术后HA的因素,并评估HA对术后短期预后的影响。
将163例行PD且符合纳入标准的患者根据HA状态分为两组。通过相关性分析评估术后白蛋白(ALB)水平和外源性ALB输注与术后反应及并发症之间的关系。
术前ALB≥35.0 g/L和术后并发症分级是影响PD术后HA的因素。相关性分析显示术后ALB水平与白细胞(WBC)计数和中性粒细胞计数呈显著负相关。术后外源性ALB输注与血尿素氮、肌酐、并发症分级、术后腹腔内出血和胰瘘呈正相关。有或无术后HA的患者并发症和30天死亡率之间无显著差异。
PD术后的HA不应被视为一个指标,而应被视为预后不良的结果。白细胞,尤其是中性粒细胞,参与降低术后ALB水平。输注外源性ALB以维持ALB>30 g/L并不能改善临床结局。