The influence of nutritional status on the incidence of postoperative complications in patients following distal pancreatectomy

Beata Jabłońska; Paweł Lampe; Sławomir Mrowiec

doi:10.5114/pg.2019.86806

The influence of nutritional status on the incidence of postoperative complications in patients following distal pancreatectomy

Prz Gastroenterol. 2020;15(1):65-75. doi: 10.5114/pg.2019.86806. Epub 2019 Jul 22.

Authors

Beata Jabłońska¹, Paweł Lampe¹, Sławomir Mrowiec¹

Affiliation

¹ Department of Digestive Tract Surgery, Medical University of Silesia, Katowice, Poland.

Abstract

Introduction: Malnutrition is a common problem in hospitalised patients. The immunological, inflammatory, and nutritional status of patients significantly influences the postoperative outcome.

Aim: To assess and analyse the influence of the nutritional status on postoperative complications in patients following distal pancreatectomy.

Material and methods: The analysis included 50 patients operated in a large centre of gastrointestinal surgery. The clinicopathological parameters were analysed, and the nutritional status was assessed. The prognostic nutritional index (PNI) was calculated as 10 × serum albumin (g/dl) + 0.005 × total lymphocyte count (per mm³). The immunological parameters, neutrophil/lymphocyte ratio (NLR), platelet/lymphocyte ratio (PLR), and lymphocyte/monocyte ratio (LMR) were calculated. Patients were divided into two groups according to the presence of early postoperative complications: those without postoperative complications and those with postoperative complications.

Results: Early postoperative complications were observed in 15 (30.0%) patients undergoing distal pancreatectomy. Postoperative pancreatic fistula (POPF) was the most frequent complication noted in 11 (22%) patients. Significantly higher Nutritional Risk Screening (NRS) 2002 (p = 0.005) and lower PNI (median value: 56 vs. 41, p = 0.0003) were noted in patients with postoperative complications. In laboratory results, the significantly lower total lymphocyte count (median value: 2.4 vs. 1.4 per mm³, p = 0.01) and serum level of albumin (median value: 4.7 vs. 3.3 g/dl, p = 0.0003) were noted in the complications group.

Conclusions: Nutritional status significantly influences the incidence of postoperative complications in patients following distal pancreatectomy. Assessment of nutritional status using PNI calculation should be the standard management of patients before surgical treatment.

Keywords: distal pancreatectomy; malnutrition; nutritional status; postoperative complications; prognostic nutritional index.