The value and prognostic significance of neutrophil / lymphocyte ratio in predicting pancreatic fistula in patients undergoing pancreaticoduodenectomy for periampullary tumors

Arıkan, Tamer; Sözüer, Erdoğan; Topal, Uğur; Dal, Fatih; Bozkurt, Gamze Kübra; Yilmaz, Ahmet Zeki

doi:10.5455/annalsmedres.2019.12.792

Cited by 1 publication

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“…It is thought to correlate with poor outcomes due to an impaired response to tumour cells and an increased risk of infective complications [ 46 ]. Whilst the mechanism behind this impaired response is poorly understood, a high NLR has been shown to correlate with poor short- and long-term PD outcomes [ 47 , 48 ], although the clinical implications of a high NLR are currently unknown. Our results showed that patients with a NLR > 3.1 more often experienced morbidity and major morbidity.…”

Section: Discussionmentioning

confidence: 99%

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Five-year follow-up after pancreatoduodenectomy performed for malignancy: A single-centre study

Russell

Labib

Aroori

2022

Ann Hepatobiliary Pancreat Surg

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The aim of this study was to describe short-and long-term outcomes of patients who underwent pancreatoduodenectomy (PD) at a typical UK hepatopancreatobiliary unit. Methods: A retrospective analysis of all PD patients with histologically-confirmed pancreatic ductal adenocarcinoma (PDAC), ampullary adenocarcinoma (AA), or distal cholangiocarcinoma (CC) from September 1st, 2006 to May 31st, 2015 was carried out. The following information was obtained: demographics, comorbidities, preoperative investigations, neoadjuvant treatment, operative details, postoperative management, complications, adjuvant treatment, five-year recurrence, and five-year survival. Effects of selected preoperative variables on short-and long-term outcomes were investigated. Results: Of 271 included patients, 57.9% had PDAC, 25.8% had AA, and 16.2% had CC. In total, 67.9% experienced morbidity and 17.3% developed a Clavien-Dindo grade ≥ III complication. The 90-day mortality was 3.3%. Clinically-relevant postoperative pancreatic fistula, bile leak, gastrojejunal leak, postpancreatectomy haemorrhage and delayed gastric emptying affected 8.1%, 4.1%, 0.0%, 9.2%, and 19.9% of patients, respectively. American Society of Anesthesiologists grade III-VI correlated with overall morbidity (p = 0.002) and major morbidity (p = 0.009), but not 90-day mortality or five-year survival. The same pattern was observed in patients with a preoperative serum bilirubin > 29 µmol/L and/or a neutrophil/lymphocyte ratio > 3.1. Five-year cancer recurrence and five-year survival were 68.3% and 22.5%, respectively. PDAC patients had higher five-year recurrence but lower five-year survival rates (both p = 0.001). Conclusions: In our series, the majority of patients experienced a complication. However, few patients experienced major morbidity. Surgical risk factors did not affect five-year survival.

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Section: Discussionmentioning

confidence: 99%

“…Other authors have also observed this. Arikan et al [ 47 ] have found that those with a high NLR show increased morbidity rates and are more likely to develop POPF. Other authors have reached similar conclusions [ 49 - 51 ].…”

Section: Discussionmentioning

confidence: 99%