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The ratio of abdominal depth to body mass index is a preoperative predictor of postoperative complications after laparoscopic pancreaticoduodenectomy: a retrospective propensity score matched analysis

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Abstract

Background

Postoperative complication rates after laparoscopic pancreaticoduodenectomy (LPD) remain high despite improvements in perioperative management. Measurements on computed tomography imaging of intra-abdominal tissue have not been thoroughly investigated as predictors of mortality and morbidity following LPD. The aim of this study was to assess whether the ratio of abdominal depth and body mass index (AD/BMI ratio) could predict postoperative complications following LPD.

Methods

We retrospectively analyzed 231 patients who underwent LPD and had a computed tomography scan between 2014 and 2018. Demographic, radiologic, and pathologic data were correlated to the occurrence of postoperative complications. Propensity score matching was performed to minimize selection biases associated with the comparison of retrospective data between the high and low AD/BMI ratio groups. Univariate and multivariate analyses were also performed to assess the risk factors for postoperative complications.

Results

Of the 102 patients identified for propensity score matching analysis, 29 patients (28.4%) experienced postoperative complications. Patients with a high AD/BMI ratio had a higher prevalence of overall complications (45.1% vs. 11.8%, P < 0.001), postoperative pancreatic fistula (17.6% vs. 2.00%, P = 0.008), delayed gastric emptying (33.3% vs. 3.90%, P < 0.001), and intra-abdominal abscess (17.6% vs. 0, P = 0.002). In the multivariate analysis, an AD/BMI ratio greater than 2.7 (m3/[kg·103]; OR = 6.16, 95% confidence interval [1.04–36.4], P = 0.045) was the only independent predictive factor of postoperative complications.

Conclusions

The preoperative AD/BMI ratio is a predictor of postoperative complications following LPD.

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Acknowledgements

We would like to thank Editage (www.editage.com) for English language editing.

Funding

This work was supported by grants from the National Natural Science Foundation of China (81772950).

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Author notes

  1. Min Wang and Renyi Qin equally contributed to this work.

Authors and Affiliations

  1. Department of Biliary-Pancreatic Surgery, Affiliated Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, 1095 Jiefang Ave, Hubei, 430030, Wuhan, China

    Hebin Wang, Jikuan Jin, Feng Zhu, Feng Peng, Min Wang & Renyi Qin

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  1. Hebin Wang
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  2. Jikuan Jin
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  3. Feng Zhu
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Correspondence to Renyi Qin.

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Drs. Hebin Wang, Jikuan Jin, Feng Zhu, Feng Peng, Min Wang, and Renyi Qin have no conflicts of interest or financial ties to disclose.

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Wang, H., Jin, J., Zhu, F. et al. The ratio of abdominal depth to body mass index is a preoperative predictor of postoperative complications after laparoscopic pancreaticoduodenectomy: a retrospective propensity score matched analysis. Surg Endosc 35, 6472–6480 (2021). https://doi.org/10.1007/s00464-020-08140-z

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