ArticleLangenbeck's archives of surgery2025
Multi-Indicator analysis of the impact of preoperative inflammatory states on complications following pancreatoduodenectomy.
Article in Langenbeck's archives of surgery, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
purposePancreatoduodenectomy (PD) is a complex surgery with a high rate of postoperative complications, for which effective preoperative indicators are currently lacking. Inflammatory indices such as the pan-immune-inflammation value (PIV), platelet-neutrophil product (PPN), and platelet-albumin ratio (PAR) have shown potential as biomarkers for postoperative prognosis in various cancers. However, their predictive value for complications in open-PD (OPD) patients remains underexplored. This study aims to investigate the relationship between these inflammatory indices and postoperative complications, identify new preoperative biomarkers, and provide a theoretical basis for improving perioperative management in OPD patients.
methodsWe analyzed data from 309 patients who underwent open-PD (OPD). Six preoperative inflammatory indices-platelet-to-lymphocyte ratio (PLR), PIV, PPN, PAR, neutrophil-to-HDL ratio (NHR), and neutrophil-albumin ratio (NAR)-were assessed for their association with postoperative complications using logistic regression and restricted cubic spline analysis. Predictive performance was evaluated with ROC curves and decision curve analysis.
resultsPLR, PIV, and PPN were significantly linked to most outcomes and had good predictive performance. NHR was associated with severe complications. PAR effectively predicted hemorrhage (AUC = 0.684) and delayed gastric emptying (DGE) (AUC = 0.701). Combining indices enhanced predictive accuracy.
conclusionsPLR, PIV, and PPN are key preoperative indicators for OPD patients, with PAR also useful for predicting complications like hemorrhage and DGE.
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