Preoperative NLR and PLR are predictive of clinically relevant postoperative pancreatic fistula
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Updated: May 31, 2025
Modified Single-Loop Reconstruction for Pancreaticoduodenectomy
Published on: September 28, 2019
Antoine El Asmar1, Elie Ghabi2, Bernard Akl3
1Department of Surgical Oncology, Institut Jules Bordet, Université Libre de Bruxelles (ULB).
Background:
Clinically relevant postoperative pancreatic fistula (CR-POPF) is a dreaded complication following pancreatic surgery. Several scores attempt to predict CR-POPF occurrence to better manage outcomes in patients undergoing pancreaticoduodenectomy (PD). In our study, we investigate the prognostic role of several demographic and clinico-pathological variables. We focus on clinical biomarkers, the Neutrophil-to-Lymphocytes Ratio (NLR) and Platelet-to-Lymphocyte ratio (PLR), which can be easily used in predicting CR-POPF occurrence.
Methods:
Patients who underwent a PD with curative intent at our institution, between 2008 and 2018 were reviewed. Statistical analysis was conducted to determine the association between various demographic and clinico-pathological variables, with the occurrence of clinically significant POPF.
Results:
117 patients underwent a PD at our institution. Statistically significant associations on multivariate analysis were observed for the absence of preoperative diabetes mellitus, a pathological stage ≥III, an elevated NLR (> 4) and an elevated PLR (> 158).
Conclusion:
The NLR and PLR are predictive of CR-POPF occurrence following PD. These readily available biomarkers can add value to risk stratification tools to assess CR-POPF occurrence and individualize patient care plans.
