Clinical Impact of the Perioperative Inflammatory Status in Pancreatic Surgery: Data from a High-Volume Center

Matteo De P, Paiella S, Ciprani D, Landoni L, Salvia R, Fumagalli L and Bassi C

Department of General and Pancreatic Surgery, University and Hospital Trust of Verona, Italy
Department of General Surgery, Hospital of Lecco, Lecco, Italy

^*Correspondance to: Matteo De P 

 PDF  Full Text DOI: 10.25107/2474-1647.2121

Abstract

Purposes: The inflammatory status is related to postoperative outcomes, and its response to surgical trauma is a significant determinant of surgical outcome, especially for infectious postoperative complications. This study aims to analyze the relationship between the immune and inflammatory indexes, assessed perioperatively, and the postoperative course after pancreatic surgery.
Methods: Data of consecutive pancreatoduodenectomies and total pancreatectomies performed at the General and Pancreatic Surgery Department of Verona from 2014 to 2016 were retrieved from a prospectively maintained electronic database and evaluated. Perioperative variations of blood count cells were recorded and then compared with postoperative outcomes.Results: The final population consisted of 554 patients. Post Operative Pancreatic Fistula (POPF), infectious complications, major complications, and mortality occurred in 75(13.5%), 261(47.1%), 85(15.3%), and 17(3%) patients, respectively. Patients with absolute and median postoperative low lymphocyte counts were associated with a worse postoperative clinical course (p<0.05). Furthermore, a preoperative Systemic-Immune-Inflammation Index (SIII) higher than 900 correlated with mortality.Conclusion: The unpaired recovery of immune effectors in the early postoperative days, expressed by low lymphocyte count and a high preoperative SIII are associated with a complicated postoperative course.

Keywords

Pancreaticoduodenectomy; Total pancreatectomy; Systemic-immune-inflammation index; Infectious complications; Lymphocyte count

Cite the article

Matteo De P, Paiella S, Ciprani D, Landoni L, Salvia R, Fumagalli L, et al. Clinical Impact of the Perioperative Inflammatory Status in Pancreatic Surgery: Data from a High-Volume Center. Clin Surg. 2018; 3: 2121.