Perioperative albumin ratio is associated with post-operative pancreatic fistula
Mario Gruppo1, Imerio Angriman1, Bruno Martella1
1Department of Surgery, Oncology and Gastroenterology, University of Padua, Padua, Italy.
Insights
Post-operative pancreatic fistula (POPF) is a risk after pancreaticoduodenectomy (PD). A perioperative albumin ratio can help predict POPF, aiding in patient management.
Area of Science:
- Surgical Oncology
- Gastroenterology
- Clinical Chemistry
Background:
- Post-operative pancreatic fistula (POPF) is a significant complication following pancreaticoduodenectomy (PD).
- Despite advancements, POPF necessitates improved predictive markers for better patient outcomes.
- Albumin levels are increasingly recognized as potential indicators in surgical recovery.
Purpose of the Study:
- To evaluate perioperative clinical variables for predicting POPF.
- To assess the predictive value of albumin levels, specifically the perioperative albumin ratio, in POPF development.
- To identify key indicators for early detection of POPF post-PD.
Main Methods:
- Prospective investigation of 86 patients undergoing PD for pancreatic cancer (2011-2017).
- Analysis of patient characteristics and incidence of clinically relevant (CR)-POPF.
- Definition of perioperative albumin ratio as POD1 albumin/preoperative albumin.
Main Results:
- CR-POPF developed in 26.7% of patients.
- Univariate analysis showed POPF correlated with soft pancreas, low POD1 albumin, and POD1/POD3 amylase levels.
- Multivariate analysis identified POD3 amylase in drainage fluid and perioperative albumin ratio as significant independent predictors (P=0.027 and P=0.047).
Conclusions:
- Perioperative albumin ratio is a valuable predictor of POPF after PD.
- This ratio, alongside POD3 amylase levels, can aid in identifying patients at risk for POPF.
- Improved prediction of POPF can lead to timely interventions and enhanced patient care.
Background:
Despite improvements in surgical techniques and perioperative management, post-operative pancreatic fistula (POPF) remains a serious complication after pancreaticoduodenectomy (PD). The aim of this study was to evaluate the role of perioperative clinical variables of patients, including albumin level, in predicting pancreatic fistula.
Methods:
A total of 86 patients underwent PD for pancreas cancer between 2011 and 2017 at our institution. We prospectively investigated the relation between patient's characteristics and the incidence of clinically relevant (CR)-POPF. Perioperative albumin ratio was defined as post-operative day 1 (POD1) albumin level/preoperative albumin level.
Results:
A total of 23 patients (26.7%) developed CR-POPF. At univariate analysis POPF correlated with soft pancreas (P = 0.045), low POD1 albumin (P = 0.02), POD1 and POD3 amylase levels in drainage fluid (P = 0.003 and P = 0.014, respectively) and perioperative albumin ratio (0.58 ± 0.10 versus 0.69 ± 0.12 in patients without POPF; P = 0.003). No significant correlations with POPF were demonstrated for surgical time, serum amylase levels and preoperative albumin levels. At multivariate analysis POD3 amylase level in drainage fluid and perioperative albumin ratio were the only significant independent parameters (P = 0.027 and P = 0.047, respectively).
Conclusions:
Perioperative albumin ratio can predict POPF after PD.
