Cao XR, Xu YL, Chai JW, Zheng K, Kong JJ, Liu J, Zheng SZ. Pretreatment red blood cell distribution width as a predictive marker for postoperative complications after laparoscopic pancreatoduodenectomy. World J Gastrointest Oncol 2025; 17(1): 98168 [DOI: 10.4251/wjgo.v17.i1.98168]
Corresponding Author of This Article
Shun-Zhen Zheng, MD, PhD, Professor, Department of Liver Transplantation and Hepatobiliary Surgery, Shandong Provincial Hospital Affiliated to Shandong First Medical University, No. 324 Jingwu Weiqi Road, Jinan 250021, Shandong Province, China. zsz5512920@hotmail.com
Research Domain of This Article
Gastroenterology & Hepatology
Article-Type of This Article
Observational Study
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
World J Gastrointest Oncol. Jan 15, 2025; 17(1): 98168 Published online Jan 15, 2025. doi: 10.4251/wjgo.v17.i1.98168
Pretreatment red blood cell distribution width as a predictive marker for postoperative complications after laparoscopic pancreatoduodenectomy
Xian-Rang Cao, Yin-Long Xu, Jia-Wei Chai, Kai Zheng, Jun-Jie Kong, Jun Liu, Shun-Zhen Zheng
Xian-Rang Cao, Yin-Long Xu, Kai Zheng, Jun-Jie Kong, Jun Liu, Shun-Zhen Zheng, Department of Liver Transplantation and Hepatobiliary Surgery, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan 250021, Shandong Province, China
Jia-Wei Chai, Department of Breast and Thyroid Surgery, Shandong Provincial Maternal and Child Health Care Hospital, Jinan 250014, Shandong Province, China
Author contributions: Liu J and Zheng SZ conceived the article; Cao XR, Xu YL, and Chai JW performed all the operations; Zheng K collected the data; Zheng K and Kong JJ provided data management and analysis support. All authors contributed to the article and approved the submitted version.
Supported by the National Natural Science Foundation of China, No. 81302124.
Institutional review board statement: This study obtained ethics approval from the ethics committee of Shandong Provincial Hospital Affiliated to Shandong First Medical University and was performed in accordance with the Declaration of Helsinki (No. 2024-498). All patients signed an informed consent form.
Informed consent statement: Patients were not required to give informed consent to the study because the analysis used anonymous data that were obtained after each patient agreed to treatment by written consent.
Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.
Data sharing statement: No additional data are available.
STROBE statement: The authors have read the STROBE Statement-checklist of items, and the manuscript was prepared and revised according to the STROBE Statement-checklist of items.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Shun-Zhen Zheng, MD, PhD, Professor, Department of Liver Transplantation and Hepatobiliary Surgery, Shandong Provincial Hospital Affiliated to Shandong First Medical University, No. 324 Jingwu Weiqi Road, Jinan 250021, Shandong Province, China. zsz5512920@hotmail.com
Received: June 19, 2024 Revised: September 10, 2024 Accepted: October 29, 2024 Published online: January 15, 2025 Processing time: 175 Days and 23.7 Hours
Abstract
BACKGROUND
Red blood cell distribution width (RDW) is associated with the development and progression of various diseases.
AIM
To explore the association between pretreatment RDW and short-term outcomes after laparoscopic pancreatoduodenectomy (LPD).
METHODS
A total of 804 consecutive patients who underwent LPD at our hospital between March 2017 and November 2021 were retrospectively analyzed. Correlations between pretreatment RDW and clinicopathological characteristics and short-term outcomes were investigated.
RESULTS
Patients with higher pretreatment RDW were older, had higher Eastern Cooperative Oncology Group scores and were associated with poorer short-term outcomes than those with normal RDW. High pretreatment RDW was an independent risk factor for postoperative complications (POCs) (hazard ratio = 2.973, 95% confidence interval: 2.032-4.350, P < 0.001) and severe POCs of grade IIIa or higher (hazard ratio = 3.138, 95% confidence interval: 2.042-4.824, P < 0.001) based on the Clavien-Dino classification system. Subgroup analysis showed that high pretreatment RDW was an independent risk factor for Clavien-Dino classification grade IIIb or higher POCs, a comprehensive complication index score ≥ 26.2, severe postoperative pancreatic fistula, severe bile leakage and severe hemorrhage. High pretreatment RDW was positively associated with the neutrophil-to-lymphocyte ratio and platelet-to-lymphocyte ratio and was negatively associated with albumin and the prognostic nutritional index.
CONCLUSION
Pretreatment RDW was a special parameter for patients who underwent LPD. It was associated with malnutrition, severe inflammatory status and poorer short-term outcomes. RDW could be a surrogate marker for nutritional and inflammatory status in identifying patients who were at high risk of developing POCs after LPD.
Core Tip: Pretreatment red blood cell distribution width was a special parameter for patients who underwent laparoscopic pancreatoduodenectomy. It was associated with malnutrition, severe inflammatory status and poorer short-term outcomes. Pretreatment red blood cell distribution width could be a surrogate marker for nutritional and inflammatory status in identifying patients who were at high risk of developing postoperative complications after laparoscopic pancreatoduodenectomy.
