Preoperative Nutritional Assessment Using the Controlling Nutritional Status Score to Predict Pancreatic Fistula After Pancreaticoduodenectomy

Utsumi, Masashi; Aoki, Hideki; Nagahisa, Seichi; Nishimura, Seitaro; Une, Yuta; Kimura, Yasutoshi; Taniguchi, Fumitaka; Arata, Toshiaki; Koh, Katsuyoshi; Tanakaya, Kohji

doi:10.21873/invivo.11990

Cited by 8 publications

(11 citation statements)

References 47 publications

(61 reference statements)

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“…5. 9 Utsumi et al [35] (2020) Japan 2008.04-2018.09 Retrospective 108 32 5 Williamsson et al [36] (2020) Sweden 2010.01-2018.06 Retrospective 2503 245 1. 6.…”

Section: Blood Transfusionmentioning

confidence: 99%

Risk factors of clinically relevant postoperative pancreatic fistula after pancreaticoduodenectomy: A systematic review and meta-analysis

Zhang

Yuan

et al. 2022

Medicine

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Background: Clinically relevant postoperative pancreatic fistula (CR-POPF) is a common and troublesome complication after pancreatoduodenectomy (PD). We conducted a systematic review and meta-analysis to identify the risk factors of CR-POPF after PD. Methods: We searched PubMed, EMBASE, and Cochrane Library databases for studies related to risk factors of CR-POPF after PD. Odds ratios (ORs) with corresponding 95% confidence intervals (CIs) were extracted from the included studies, then a meta-analysis was conducted. If necessary, sensitivity analysis would be performed by changing the effect model or excluding 1 study at a time. Publication bias was assessed by funnel plot and Begg test and Egger test. Results: A total of 27 studies with 24,740 patients were included, and CR-POPF occurred in 3843 patients (incidence = 17%, 95% CI: 16%–19%). Male (OR = 1.56, 95% CI: 1.42–1.70), body mass index >25 kg/m 2 (OR = 1.98, 95% CI: 1.23–3.18), pancreatic duct diameter <3 mm (OR = 1.87, 95% CI: 1.66–2.12), soft pancreatic texture (OR = 3.49, 95% CI: 2.61–4.67), and blood transfusion (OR = 3.10, 95% CI: 2.01–4.77) can significantly increase the risk of CR-POPF. Pancreatic adenocarcinoma (OR = 0.54, 95% CI: 0.47–0.61), vascular resection (OR = 0.57, 95% CI: 0.39–0.83), and preoperative chemoradiotherapy (OR = 0.68, 95% CI: 0.57–0.81) can significantly decrease the factor of CR-POPF. Diabetes mellitus was not statistically associated with CR-POPF (OR = 0.66, 95% CI: 0.40–1.08). However, the analysis of body mass index, pancreatic texture, and diabetes mellitus had a high heterogeneity, then sensitivity analysis was performed, and the result after sensitivity analysis showed diabetes mellitus can significantly decrease the risk of CR-POPF. There was no significant publication bias in this meta-analysis. Conclusions: The current review assessed the effects of different factors on CR-POPF. This can provide a basis for the prevention and management of CR-POPF. Effective interventions targeting the above risk factors should be investigated in future studies for decreasing the occurrence of CR-POPF.

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“…5. 9 Utsumi et al [35] (2020) Japan 2008.04-2018.09 Retrospective 108 32 5 Williamsson et al [36] (2020) Sweden 2010.01-2018.06 Retrospective 2503 245 1. 6.…”

Section: Blood Transfusionmentioning

confidence: 99%

Risk factors of clinically relevant postoperative pancreatic fistula after pancreaticoduodenectomy: A systematic review and meta-analysis

Zhang

Yuan

et al. 2022

Medicine

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“…Utsumi et al [39] reported that the preoperative nutritional assessment using the Controlling Nutritional Status (CONUT) Score may predict the pancreatic fistula after PD. The CONUT score is a tool used to assess nutritional status.…”

Section: Immunomodulating Mechanisms Of Nutrients Used In Inmentioning

confidence: 99%

“…The authors concluded that patients with high CONUT scores were at high risk for POPF. According to them, preoperative immunonutrition might help reduce the POPF risk in these patients through modulating impaired immunity in them [39]. It regards the clinically relevant POPF classified as grade B and C, according to the International Study Group on Pancreatic Fistula classification [40].…”

Section: Immunomodulating Mechanisms Of Nutrients Used In Inmentioning

confidence: 99%

“…In the case of organ failure occurring, a grade C POPF is recognized. Therefore, immunomodulating influences not only typical infectious complications, but can also decrease the risk of POPF-the common complication following PD (incidence 11.4-64.3% of PD) [39].…”

Section: Immunomodulating Mechanisms Of Nutrients Used In Inmentioning

confidence: 99%

“…The positive role of Gln on prognosis has been proven in critically ill patients [36,[47][48][49][50]. However, data regarding the use of Gln in these patients are also contradictory [39,[47][48][49][50][51][52][53][54][55][56], because not all studies have confirmed this theory. Some authors have proven that high doses of Gln are associated with an increased mortality rate in critically ill patients [52][53][54][55][56].…”

Section: Glutamine (Gln)mentioning

confidence: 99%

See 2 more Smart Citations

The Role of Immunonutrition in Patients Undergoing Pancreaticoduodenectomy

Jabłońska

Mrowiec

2020

Nutrients

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Pancreaticoduodenectomy (PD) is one of the most difficult and complex surgical procedures in abdominal surgery. Malnutrition and immune dysfunction in patients with pancreatic cancer (PC) may lead to a higher risk of postoperative infectious complications. Although immunonutrition (IN) is recommended for enhanced recovery after surgery (ERAS) in patients undergoing PD for 5–7 days perioperatively, its role in patients undergoing pancreatectomy is still unclear and controversial. It is known that the proper surgical technique is very important in order to reduce a risk of postoperative complications, such as a pancreatic fistula, and to improve disease-free survival in patients following PD. However, it has been proven that IN decreases the risk of infectious complications, and shortens hospital stays in patients undergoing PD. This is a result of the impact on altered inflammatory responses in patients with cancer. Both enteral and parenteral, as well as preoperative and postoperative IN, using various nutrients, such as glutamine, arginine, omega-3 fatty acids and nucleotides, is administered. The most frequently used preoperative oral supplementation is recommended. The aim of this paper is to present the indications and benefits of IN in patients undergoing PD.

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Analysis of preoperative nutrition, immunity and inflammation correlation index on the prognosis of upper tract urothelial carcinoma surgical patients: a retrospective single center study

Ou,

Zheng,

Wang

et al. 2024

BMC Surg

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Background SII, PNI, SIRI, AAPR, and LIPI are prognostic scores based on inflammation, nutrition, and immunity. The purpose of this study was to examine the prognostic value of the SII, PNI, SIRI, AAPR, and LIPI in patients with UTUC who underwent radical nephroureterectomy with bladder cuff excision. Materials and methods Data of UTUC patients in Sichuan Provincial People's Hospital from January 2017 to December 2021 were collected. The optimal critical values of SII, PNI, SIRI, and AAPR were determined by ROC curve, and LIPI was stratified according to the dNLR and LDH. The Kaplan–Meier method was used to draw the survival curve, and Cox proportional hazard model was used to analyze the factors affecting the prognosis of UTUC patients. Results A total of 81 patients with UTUC were included in this study. The optimal truncation value of PNI, SII, SIRI and AAPR were determined to be 48.15, 596.4, 1.45 and 0.50, respectively. Univariate Cox proportional hazard regression showed that low PNI, high SII, high SIRI, low AAPR and poor LIPI group were effective predictors of postoperative prognosis of UTUC patients. Multivariate Cox proportional hazard regression showed that high SII was an independent risk factor for postoperative prognosis of UTUC patients. According to ROC curve, the prediction efficiency of fitting indexes of PNI, SII, SIRI, AAPR and LIPI is better than that of using them alone. Conclusions The SII, PNI, SIRI, AAPR, and LIPI was a potential prognostic predictor in UTUC patients who underwent radical nephroureterectomy with bladder cuff excision.

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Preoperative Nutritional Assessment Using the Controlling Nutritional Status Score to Predict Pancreatic Fistula After Pancreaticoduodenectomy

Cited by 8 publications

References 47 publications

Risk factors of clinically relevant postoperative pancreatic fistula after pancreaticoduodenectomy: A systematic review and meta-analysis

Risk factors of clinically relevant postoperative pancreatic fistula after pancreaticoduodenectomy: A systematic review and meta-analysis

The Role of Immunonutrition in Patients Undergoing Pancreaticoduodenectomy

Analysis of preoperative nutrition, immunity and inflammation correlation index on the prognosis of upper tract urothelial carcinoma surgical patients: a retrospective single center study

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