Published online Sep 16, 2023. doi: 10.12998/wjcc.v11.i26.6051
Peer-review started: April 27, 2023
First decision: July 6, 2023
Revised: July 25, 2023
Accepted: August 7, 2023
Article in press: August 7, 2023
Published online: September 16, 2023
Processing time: 133 Days and 22 Hours
Pancreatoduodenectomy remains associated with high rates of severe morbidity, even in high-volume centres.
Understanding and recognition of possible complications is essential when providing adequate care for patients after pancreatoduodenectomy. Prognostic tools, including preoperatively obtained patient-related factors, could help identify patients at high risk for postoperative complications, tailor their perioperative management accordingly, and ultimately improve treatment outcomes. The predictive and prognostic value of albumin-bilirubin (ALBI) score has been evaluated in several patient cohorts, but not in patients after pancreatoduodenectomy.
Clinical significance of the preoperative ALBI score and other risk factors in relation to short-term postoperative outcomes in patients after pancreatoduodenectomy was evaluated.
Electronic data of 347 patients who underwent a pancreatoduodenectomy in a five-year period were retrospectively reviewed. Multiple logistic regression models were built to identify risk factors associated with short-term postoperative outcomes.
Upon conducting univariate analysis, no statistically significant association was found between the ALBI score and any of the short-term postoperative outcomes. However, when considering other predictor variables in a logistic regression model, certain risk factors exhibited statistically significant association.
The ALBI score failed to predict short-term postoperative outcomes in our study. Nonetheless, other risk factors, including male sex, soft pancreatic texture, blood loss, and resection due to duodenal carcinoma seem to exert an influence. In case of their recognition, the operating surgeon may consider alternative management options to avoid unfavourable treatment outcomes.
Only ALBI score was evaluated in our study as current cut-off values to determine ALBI grades have originally been validated for chronic liver disease. The optimal cut-off values in the setting of pancreatoduodenectomy remain to be investigated prospectively in a larger patient cohort to ensure optimal sensitivity and specificity.