Clinical significance of preoperative nutritional parameter and patient outcomes after pancreatectomy: A retrospective study at two academic institute

Atsushi Nanashima; Masahide Hiyoshi; Naoya Imamura; Koichi Yano; Takeomi Hamada; Rouko Hamada; Kenzo Nagatomo; Makoto Ikenoue; Shuichi Tobinaga; Takeshi Nagayasu

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저자정보: Atsushi Nanashima (University of Miyazaki Faculty of Medicine) Masahide Hiyoshi (University of Miyazaki Faculty of Medicine) Naoya Imamura (University of Miyazaki Faculty of Medicine) Koichi Yano (University of Miyazaki Faculty of Medicine) Takeomi Hamada (University of Miyazaki Faculty of Medicine) Rouko Hamada (University of Miyazaki Faculty of Medicine) Kenzo Nagatomo (University of Miyazaki Faculty of Medicine) Makoto Ikenoue (University of Miyazaki Faculty of Medicine) Shuichi Tobinaga (Nagasaki University School of Biomedical Sciences) Takeshi Nagayasu (Nagasaki University School of Biomedical Sciences)

저널정보: 한국간담췌외과학회 Annals of Hepato-Biliary-Pancreatic Surgery 한국간담췌외과학회지 제23권 제2호

발행연도: 2019.5

수록면: 168 - 173 (6page)

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Backgrounds/Aims: Preoperative nutritional status has been reported to influence patient outcomes after pancreatectomy. The Prognostic Nutritional Index (PNI) is a useful parameter to reflect the outcomes of patients undergoing gastrointestinal surgery. Therefore, the relationship between the PNI and clinicopathological factors, surgical data, and postoperative morbidity were retrospectively evaluated at two academic institutes in a cohort study. Methods: Curative pancreatectomy was performed on 222 patients at the University of Nagasaki between 1995 and March 2015, and 101 at the University of Miyazaki between April 2015and March 2018. The PNI was calculated using preoperative albumin and total cholesterol levels. Results: The mean PNI in our series was 39.2±5.4 and the prevalence of PNIs less than 40 was observed in 134 patients (44%). The PNI was not significantly different between normal, hard, and fatty architecture of the pancreatic parenchyma. The PNIs were significantly negatively correlated with higher age (p＜0.01), but not with gender, co-morbidity, or habits. The PNI was significantly correlated with levels of hemoglobin, prothrombin activity, choline esterase, total protein, albumin and cholesterol (p＜0.01), and with postoperative total protein and albumin levels (p＜0.05). Although the preoperative PNI tended to be lower in patients with total postoperative complications, no significant differences for each complication were observed. Conclusions: Although the preoperative PNIs reflect the perioperative nutritional status, its predictive usefulness for postoperative complications could not be significantly confirmed.

#Prognostic nutritional index #Pancreatectomy #Postoperative nutritional parameters #Postoperative complications

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