Shiozaki Hironori, Fujioka Shuichi, Takano Yuki, Shimazaki Takashi, Suka Machi, Sakamoto Taro, Gocho Takeshi, Nakamoto Keitaro, Toya Naoki, Ikegami Toru
Department of Surgery, The Jikei University Kashiwa Hospital, 163-1 KashiwashitaKashiwa-shi, Chiba, 227-8567, Japan.
Department of Public Health and Environmental Medicine, The Jikei University School of Medicine, 3-25-8 Nishishinbashi, Minato-City, Tokyo, 105-8461, Japan.
Surg Today. 2025 Sep 15. doi: 10.1007/s00595-025-03128-5.
Pancreaticoduodenectomy is associated with high morbidity, notably due to complications, such as postoperative pancreatic fistula and intra-abdominal hemorrhaging. The early detection of such complications is crucial for improving outcomes. The peripheral blood eosinophil ratio, which reflects the endogenous corticosteroid activity, may indicate physiological stress or inflammation. This study evaluated whether or not changes in the eosinophil ratio could predict postoperative complications.
A retrospective review of patients who underwent pancreaticoduodenectomy between January 2011 and December 2020 at Jikei University Kashiwa Hospital was conducted. The postoperative eosinophil ratio trends were analyzed in relation to complications.
Among 200 patients, 85 experienced Clavien-Dindo grade ≥ III complications. A biphasic pattern in the eosinophil ratio was observed in these patients, with a secondary decline correlating with the onset of complications. Using a cutoff of 0.95%, the sensitivity, specificity, and area under the curve for predicting severe complications were 0.92, 0.92, and 0.96, respectively (95% confidence interval 0.93-0.99).
A sustained decrease in the peripheral blood eosinophil ratio was associated with severe postoperative complications. This marker may be useful for early detection, enabling prompt diagnostic and therapeutic intervention following pancreaticoduodenectomy.
胰十二指肠切除术的发病率较高，尤其是由于术后胰瘘和腹腔内出血等并发症所致。早期发现此类并发症对于改善预后至关重要。反映内源性皮质类固醇活性的外周血嗜酸性粒细胞比率可能表明生理应激或炎症。本研究评估了嗜酸性粒细胞比率的变化是否能够预测术后并发症。
对2011年1月至2020年12月在东京慈惠会医科大学柏医院接受胰十二指肠切除术的患者进行回顾性研究。分析术后嗜酸性粒细胞比率趋势与并发症的关系。
200例患者中，85例出现Clavien-Dindo≥Ⅲ级并发症。在这些患者中观察到嗜酸性粒细胞比率呈双相模式，继发性下降与并发症的发生相关。以0.95%为临界值，预测严重并发症的敏感性、特异性和曲线下面积分别为0.92、0.92和0.96（95%置信区间0.93-0.99）。
外周血嗜酸性粒细胞比率持续下降与严重术后并发症相关。该指标可能有助于早期发现，从而在胰十二指肠切除术后能够及时进行诊断和治疗干预。
