Preoperative Prognostic Nutritional Index is a significant predictive factor for posthepatectomy bile leakage

Atsushi Nanashima; Masahide Hiyoshi; Naoya Imamura; Koichi Yano; Takeomi Hamada; Kengo Kai; Takahiro Nishida; Yukako Uchise; Risa Sakamoto; Mayu Inomata

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자료유형: 학술저널

저자정보: Atsushi Nanashima (University of Miyazaki Faculty of Medicine) Masahide Hiyoshi (University of Miyazaki Faculty of Medicine) Naoya Imamura (University of Miyazaki Faculty of Medicine) Koichi Yano (University of Miyazaki Faculty of Medicine) Takeomi Hamada (University of Miyazaki Faculty of Medicine) Kengo Kai (University of Miyazaki Faculty of Medicine) Takahiro Nishida (University of Miyazaki Faculty of Medicine) Yukako Uchise (University of Miyazaki Faculty of Medicine) Risa Sakamoto (University of Miyazaki Faculty of Medicine) Mayu Inomata (University of Miyazaki Faculty of Medicine)

저널정보: 한국간담췌외과학회 Annals of Hepato-Biliary-Pancreatic Surgery 한국간담췌외과학회지 제25권 제4호

발행연도: 2021.11

수록면: 477 - 484 (8page)

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Backgrounds/Aims: It is known that preoperative nutritional status can influence patient outcomes after hepatectomy. Prognostic Nutritional Index (PNI) is a useful parameter to reflect patient outcomes undergoing gastro-intestinal surgery. The aim of this study was to retrospectively evaluate relationships of nutritional parameters, demographics, and surgical records with postoperative outcomes in a cohort study.
Methods: Curative hepatectomy was performed for 182 patients at the University of Miyazaki between 2015 and 2018. Each preoperative level of albumin, prealbumin, lymphocyte, total cholesterol, or the comprehensively calculated Onodera’s PNI was examined as a nutritional parameter.
Results: The mean PNI was 39.6 ± 5.1, with PNI below 40 observed in 91 (50.0%) patients. Nutritional parameters were not different among patients with various liver diseases. Serum albumin or prealbumin level was significantly correlated with each hepatic parameter (p < 0.01). Prealbumin and total cholesterol levels were significantly correlated with postoperative prothrombin activity (p < 0.05). Albumin or prealbumin levels and PNI were significantly lower in patients with posthepatectomy complications, particularly bile leakage in comparison those without such complications (p < 0.05). Multiple logistic analysis showed that albumin level was an independent risk factor for complications after hepatectomy (risk ratio [RR]: 1.33) and that lymphocyte count was an independent risk factor for bile leakage (RR: 1.28) (p < 0.05). The cut-off level of albumin was approximately 3.8 mg/dL and that of lymphocyte count was 1,320/㎣.
Conclusions: Preoperative PNI reflected perioperative liver functional status. It was a predictive parameter for postoperative complications, particularly biliary leakage.

#Prognostic Nutritional Index #Postoperative nutritional parameters #Hepatectomy #Postoperative complications

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