Retrospective analysis of delta hemoglobin and bleeding-related risk factors in pancreaticoduodenectomy

doi:10.4240/wjgs.v17.i3.100999

Advanced Search

BPG is committed to discovery and dissemination of knowledge

Home / Archive / Volume 17, Issue 3

This Article

Academic Content and Language Evaluation of This Article

CrossCheck and Google Search of This Article

Academic Rules and Norms of This Article

Citation of this article

Corresponding Author of This Article

Research Domain of This Article

Article-Type of This Article

Open-Access Policy of This Article

Times Cited Counts in Google of This Article

Number of Hits and Downloads for This Article

Total Article Views (0)

All Articles published online

The chart showing PDF series, HTML series, Tables (1-9) series.

Item

Count

PDF

HTML

Tables (1-9)

Sum=0

Mar 27, 2025 (publication date) through Feb 24, 2025

Times Cited of This Article

Times Cited (0)

Journal Information of This Article

Publication Name

World Journal of Gastrointestinal Surgery

ISSN

1948-9366

Publisher of This Article

Baishideng Publishing Group Inc, 7041 Koll Center Parkway, Suite 160, Pleasanton, CA 94566, USA

Retrospective Study

World J Gastrointest Surg. Mar 27, 2025; 17(3): 100999
Published online Mar 27, 2025. doi: 10.4240/wjgs.v17.i3.100999

Table 1 Comparison of the general patient characteristics among the three groups, n (%)

Characteristic	OPD (n = 511)	LPD (n = 982)	CTOPD (n = 229)	P value
Sex
Male	312 (61.1)	616 (62.7)	155 (67.7)	0.223
Female	199 (38.9)	366 (37.3)	74 (32.3)	-
Age (years), interquartile range	61 (54.0-67.0)	61 (53.0-67.0)	61 (52.0-69.0)	0.992
BMI (kg/m²), interquartile range	23.83 (21.48-26.03)	23.69 (21.77-25.95)	23.68 (21.62-26.22)	0.997
History of abdominal surgery
Yes	83 (16.2)	135 (13.7)	33 (14.4)	0.430
No	428 (83.8)	847 (86.3)	296 (85.6)	-
History of diabetes
Yes	98 (19.2)	166 (16.9)	38 (16.6)	0.506
No	413 (80.8)	816 (83.1)	191 (83.4)	-
Preoperative alkaline phosphatase (U/L), interquartile range	301.0 (126.0-516.0)	283.5 (119.75-510.25)	246.0 (97.0-459.5)	0.079
Preoperative glutamyl transpeptidase (U/L), interquartile range	336.0 (84.0-801.0)	372.0 (78.5-806.5)	267.0 (45.0-716.0)	0.132
Preoperative Hb (g/L), interquartile range	127.0 (115.0-138.0)	126.0 (114.0-136.0)	125.0 (114.0-139.0)	0.696
Preoperative albumin (g/L), interquartile range	38.7 (35.4-41.7)	38.5 (35.5-41,4)	38.2 (34.8-41.2)	0.482
ASA classification
I	2 (0.4)	3 (0.3)	0 (0)	0.905
II	358 (70.1)	701 (71.4)	160 (69.9)	-
III	147 (28.8)	274 (27.9)	68 (29.7)	-
IV	4 (0.8)	4 (0.4)	1 (0.4)	-
Preoperative total bilirubin (μmol/L), interquartile range	82.57 (17.65-197.68)	73.25 (17.97-204.36)	60.07 (14.91-204.55)	0.441

OPD: Open pancreaticoduodenectomy; LPD: Laparoscopic pancreaticoduodenectomy; CTOPD: Conversion to open pancreaticoduodenectomy; BMI: Body mass index; Hb: Hemoglobin; ASA: American Society of Anesthesiologists.

Table 2 Comparison of mortality rates among the three groups, n (%)

Characteristic	OPD (n = 511)	LPD (n = 982)	CTOPD (n = 229)	P value
Perioperative death
Yes	4 (0.8)	13 (1.3)	2 (0.9)	0.598
No	507 (99.2)	969 (98.7)	227 (99.1)	-

OPD: Open pancreaticoduodenectomy; LPD: Laparoscopic pancreaticoduodenectomy; CTOPD: Conversion to open pancreaticoduodenectomy.

Table 3 Comparison of estimated blood loss and delta hemoglobin among the three groups

Blood loss	OPD (n = 511)	LPD (n = 982)	CTOPD (n = 229)	P value
EBL (mL), interquartile range	200.0 (50.0-300.0)	50.0 (50.0-200.0)	200.0 (50.0-400.0)	< 0.001
IΔHb (g/L), interquartile range	22.00 (12.00-6.00)	21.00 (10.00-33.00)	33.00 (18.12-52.24)	< 0.001
PΔHb (g/L), interquartile range	25.87 (13.51-42.00)	25.00 (14.00-45.00)	37.48 (21.64-59.65)	< 0.001

OPD: Open pancreaticoduodenectomy; LPD: Laparoscopic pancreaticoduodenectomy; CTOPD: Conversion to open pancreaticoduodenectomy; EBL: Estimated blood loss; IΔHb: Intraoperative delta hemoglobin; PΔHb: Perioperative delta hemoglobin.

Table 4 Correlation analysis between intraoperative delta hemoglobin and estimated blood loss

Classification	Spearman correlation coefficient	P value
IΔHb (g/L)	-	-
EBL (mL)	0.337	< 0.001

EBL: Estimated blood loss; IΔHb: Intraoperative delta hemoglobin.

Table 5 Comparison of intraoperative delta hemoglobin and perioperative delta hemoglobin

Classification	ΔHb (g/L)	Z value	P value
IΔHb, interquartile range	22.00 (11.00-36.00)	-	-
PΔHb, interquartile range	27.00 (14.00-45.49)	-10.729	< 0.001

ΔHb: Delta hemoglobin; IΔHb: Intraoperative delta hemoglobin; PΔHb: Perioperative delta hemoglobin.

Table 6 Univariate regression analysis of intraoperative delta hemoglobin

Parameter	B value	95%CI	P value
Age ≥ 65 years	0.236	-2.429-2.901	0.862
History of diabetes	0.724	-2.658-4.107	0.674
History of abdominal surgery	-1.076	-4.721-2.569	0.563
Preoperative biliary drainage	-2.606	-5.948-0.735	0.126
ASA classification IV	19.236	1.420-37.052	0.034
BMI > 24 kg/m²	2.605	0.031-5.179	0.047
Malignant tumor	-0.717	-4.380-2.946	0.701
Preoperative albumin < 35 g/L	1.834	-1.288-4.955	0.249
Pancreatic tumor	1.737	-0.973-4.447	0.209
Pancreatic carcinoma	2.041	-0.851-4.933	0.166
Ampulla of Vater carcinoma	-0.921	-5.055-3.214	0.662
Preoperative total bilirubin > 200 μmol/L	5.800	2.861-8.738	< 0.001

CI: Confidence interval; ASA: American Society of Anesthesiologists; BMI: Body mass index.

Table 7 Multivariate regression analysis of intraoperative delta hemoglobin

Parameter	B value	95%CI	P value
ASA classification IV	20.071	2.330-37.811	0.049
BMI > 24 kg/m²	2.576	0.013-5.140	0.078
Preoperative total bilirubin > 200 μmol/L	5.739	2.805-8.673	< 0.001

CI: Confidence interval; ASA: American Society of Anesthesiologists; BMI: Body mass index.

Table 8 Univariate regression analysis of perioperative delta hemoglobin

Parameter	B value	95%CI	P value
Age ≥ 65 years	-0.293	-4.804-4.219	0.899
History of diabetes	-3.663	-9.385-2.060	0.210
History of abdominal surgery	3.798	-2.369-9.966	0.227
Preoperative biliary drainage	-4.268	-9.924-1.389	0.139
ASA classification IV	73.919	43.926-103.911	< 0.001
BMI > 24 kg/m²	5.468	1.114-9.822	0.014
Malignant tumor	1.284	-4.916-7.485	0.685
Preoperative albumin < 35 g/L	0.778	-4.507-6.064	0.773
Pancreatic tumor	-0.076	-4.665-4.514	0.974
Pancreatic carcinoma	-0.469	-5.367-4.428	0.851
Ampulla of Vater carcinoma	1.670	-5.327-8.668	0.640
Preoperative total bilirubin > 200 μmol/L	11.975	7.011-16.938	< 0.001

CI: Confidence interval; ASA: American Society of Anesthesiologists; BMI: Body mass index.

Table 9 Multivariate regression analysis of perioperative delta hemoglobin

Parameter	B value	95%CI	P value
ASA classification IV	75.710	45.934-105.485	< 0.001
BMI > 24 kg/m²	5.588	1.285-9.890	0.011
Preoperative total bilirubin > 200 μmol/L	11.872	6.948-16.797	< 0.001

CI: Confidence interval; ASA: American Society of Anesthesiologists; BMI: Body mass index.

Citation: Lin YM, Yu C, Xian GZ. Retrospective analysis of delta hemoglobin and bleeding-related risk factors in pancreaticoduodenectomy. World J Gastrointest Surg 2025; 17(3): 100999
URL: https://www.wjgnet.com/1948-9366/full/v17/i3/100999.htm
DOI: https://dx.doi.org/10.4240/wjgs.v17.i3.100999