Lymphopenia following pancreaticoduodenectomy is associated with pancreatic fistula formation.
Lymphopenia
Pancreaticoduodenectomy
Post-operative pancreatic fistula
Journal
Annals of hepato-biliary-pancreatic surgery
ISSN: 2508-5859
Titre abrégé: Ann Hepatobiliary Pancreat Surg
Pays: Korea (South)
ID NLM: 101698342
Informations de publication
Date de publication:
31 May 2021
31 May 2021
Historique:
received:
06
09
2020
revised:
07
12
2020
accepted:
31
12
2020
entrez:
31
5
2021
pubmed:
1
6
2021
medline:
1
6
2021
Statut:
ppublish
Résumé
Post-operative pancreatic fistulas (POPF) are a major source of morbidity following pancreaticoduodenectomy (PD). This study aims to investigate if persistent lymphopenia, a known marker of sepsis, can act as an additional marker of POPF with clinical implications that could help direct drain management. A retrospective chart review of all patients who underwent PD in a single hospital network from 2008 to 2018. Persistent lymphopenia was defined as lymphopenia beyond post-operative day #3. Of the 201 patients who underwent PD during the study period 161 patients had relevant laboratory data, 81 of whom had persistent lymphopenia. 17 patients with persistent lymphopenia went on to develop a POPF, compared to 7 patients without. Persistent lymphopenia had a negative predictive value of 91.3%. Multivariate analysis revealed only persistent lymphopenia as being independently associated with POPF (HR 2.57, 95% CI 1.07-6.643, Persistent lymphopenia is a readily available early marker of POPF that holds the potential to identify clinically relevant POPF in patients where no surgical drain is present, and to act as an adjunct of drain amylase helping to guide drain management.
Sections du résumé
BACKGROUNDS/AIMS
OBJECTIVE
Post-operative pancreatic fistulas (POPF) are a major source of morbidity following pancreaticoduodenectomy (PD). This study aims to investigate if persistent lymphopenia, a known marker of sepsis, can act as an additional marker of POPF with clinical implications that could help direct drain management.
METHODS
METHODS
A retrospective chart review of all patients who underwent PD in a single hospital network from 2008 to 2018. Persistent lymphopenia was defined as lymphopenia beyond post-operative day #3.
RESULTS
RESULTS
Of the 201 patients who underwent PD during the study period 161 patients had relevant laboratory data, 81 of whom had persistent lymphopenia. 17 patients with persistent lymphopenia went on to develop a POPF, compared to 7 patients without. Persistent lymphopenia had a negative predictive value of 91.3%. Multivariate analysis revealed only persistent lymphopenia as being independently associated with POPF (HR 2.57, 95% CI 1.07-6.643,
CONCLUSIONS
CONCLUSIONS
Persistent lymphopenia is a readily available early marker of POPF that holds the potential to identify clinically relevant POPF in patients where no surgical drain is present, and to act as an adjunct of drain amylase helping to guide drain management.
Identifiants
pubmed: 34053927
pii: ahbps.2021.25.2.242
doi: 10.14701/ahbps.2021.25.2.242
pmc: PMC8180408
doi:
Types de publication
Journal Article
Langues
eng
Pagination
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