Prognostic Nutritional Index in Short-term Postoperative Outcomes in Hepaticojejunostomy

To investigate the utility of prognostic nutritional index (PNI) on short-term complications, biliary fistula, mortality, and morbidity in patients undergoing hepaticojejunostomy (HJ) procedure.

Observational study.

Tepecik Training and Research Hospital, Izmir, Turkey, between January 2018 and January 2020.

Patients who underwent elective HJ for benign and malignant reasons were scanned retrospectively using the hospital digital record system. Many data such as chronic diseases and PNI values of patients, postoperative 30-day mortality and morbidity, days of hospital stay (HS), postoperative complications, and data of surgery were analyzed.

A total of 81 patients, of whom 42 (52%) were males and 39 (48%) were females, were included in the study. The mean age of the patients was 65.8 ±11.3. In 53 patients (65.4%), surgeries were performed due to malignancy. In 19 (23.4%) patients, grade 3 and 4 complications according to Clavien-Dindo Classification were observed in 12 patients (14.8%), and postoperative 30-day mortality was observed. The rate of grade 3 and 4 complications increased in patients with a PNI below 45, it was not statistically significant (p=0.165). The mortality rate was 4.5% in patients with PNI>45, and 18.6% in patients with PNI<45 but this difference was not significant (p=0.165). The mean HS was significantly shorter in patients with PNI>45 (p=0.02).

At PNI>45, many complications and hospital stay become markedly shorter. Large multi-centre randomised future studies are required to confirm these findings.

Prognostic nutritional index, Hepatic duct, Biliary tract, Biliary fistula.