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Albumin difference as a new predictor of pancreatic fistula following distal pancreatectomy: a retrospective study of 211 consecutive patients

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Abstract

Purpose

The level of albumin declines after surgery, and whether the difference between preoperative and postoperative albumin levels on postoperative day 1 has an effect on the development of postoperative pancreatic fistula (POPF) after distal pancreatectomy (DP) is unclear. Our aim was to evaluate the effect of albumin difference on POPF.

Methods

A retrospective analysis of consecutive patients who had undergone DP between January 2016 and October 2018 at a single institution was conducted. Patient demographic data and perioperative data were analysed using univariate and multivariate models. Pancreatic fistula was defined by the 2016 International Study Group of Pancreatic Surgery criteria. All patients were followed for up to 90 days.

Results

A total of 211 consecutive patients were identified. The POPF rate was 15.64%, and no 90-day mortality was observed. Five predictors were independently associated with POPF: albumin difference (OR 6.60, 95% CI 2.36–18.45, P < 0.001), pancreatic texture (OR 4.15, 95% CI 1.62–10.63, P = 0.003), operative time (OR 3.13, 95% CI 1.19–8.24, P = 0.021), intraoperative fluid transfusion (OR 4.85, 95% CI 1.70–13.79, P = 0.003), and cardiovascular disease (OR 5.38, 95% CI 1.99–14.55, P = 0.001).

Conclusions

Although DP can be performed with a low rate of mortality, POPF remains a common complication. Albumin difference is a new, accessible predictor for POPF following DP.

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Authors and Affiliations

  1. Department of Pancreatic Surgery, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology|, Wuhan, 430022, China

    Jian Shen, Yushun Zhang, Ruozheng Wei & Heshui Wu

  2. Department of Breast and Thyroid Surgery, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430022, China

    Jin Hu

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  1. Jian Shen
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  3. Jin Hu
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  5. Heshui Wu
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Contributions

HSW, YSZ, and JS contributed in the study conception and design; JS, RZW, and JH provided data acquisition; JS, YSZ, and JH provided statistical analysis; JS, JH, and RZW participated in manuscript preparation; and HSW and YSZ contributed in manuscript revision. All authors have reviewed the manuscript.

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Correspondence to Heshui Wu.

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The authors declare that they have no conflicts of interest.

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Written informed consent from patients was obtained before participation. Our study complied with the ethical standards of the institutional research committee and with the Helsinki declaration.

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Shen, J., Zhang, Y., Hu, J. et al. Albumin difference as a new predictor of pancreatic fistula following distal pancreatectomy: a retrospective study of 211 consecutive patients. Langenbecks Arch Surg 405, 55–62 (2020). https://doi.org/10.1007/s00423-019-01849-z

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  • DOI: https://doi.org/10.1007/s00423-019-01849-z

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