Yu C, Lin YM, Xian GZ. Hemoglobin loss method calculates blood loss during pancreaticoduodenectomy and predicts bleeding-related risk factors. World J Gastrointest Surg 2024; 16(2): 419-428 [PMID: 38463360 DOI: 10.4240/wjgs.v16.i2.419]
Corresponding Author of This Article
Guo-Zhe Xian, MD, PhD, Chief Doctor, Professor, Department of Hepatobiliary Surgery, Shandong Provincial Hospital Affiliated to Shandong First Medical University, No. 324 Jingwu Weiqi Road, Huaiyin District, Jinan 250021, Shandong Province, China. xianguozhe@sdfmu.edu.cn
Research Domain of This Article
Surgery
Article-Type of This Article
Retrospective 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 Surg. Feb 27, 2024; 16(2): 419-428 Published online Feb 27, 2024. doi: 10.4240/wjgs.v16.i2.419
Hemoglobin loss method calculates blood loss during pancreaticoduodenectomy and predicts bleeding-related risk factors
Chao Yu, Yi-Min Lin, Guo-Zhe Xian
Chao Yu, Yi-Min Lin, Guo-Zhe Xian, Department of Hepatobiliary Surgery, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan 250021, Shandong Province, China
Author contributions: Yu C designed the study, collected and analyzed data, and wrote the manuscript; Lin YM participated in the study’s conception and data collection; Xian GZ participated in study design and provided guidance; All authors read and approved the final version.
Supported byShandong Provincial Natural Science Foundation General Project, No. ZR2020MH248.
Institutional review board statement: This study was reviewed and approved by the Ethics Committee of the Shandong Provincial Hospital Affiliated to Shandong First Medical University (Shandong Provincial Hospital).
Informed consent statement: Patients were not required to give informed consent to the study because the analysis used anonymous clinical data that were obtained after each patient agreed to treatment by written consent.
Conflict-of-interest statement: We have no financial relationships to disclose.
Data sharing statement: No additional data are available.
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 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: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Guo-Zhe Xian, MD, PhD, Chief Doctor, Professor, Department of Hepatobiliary Surgery, Shandong Provincial Hospital Affiliated to Shandong First Medical University, No. 324 Jingwu Weiqi Road, Huaiyin District, Jinan 250021, Shandong Province, China. xianguozhe@sdfmu.edu.cn
Received: September 24, 2023 Peer-review started: September 24, 2023 First decision: December 14, 2023 Revised: December 26, 2023 Accepted: January 19, 2024 Article in press: January 19, 2024 Published online: February 27, 2024 Processing time: 152 Days and 4.5 Hours
ARTICLE HIGHLIGHTS
Research background
The most common way to evaluate blood loss during pancreaticoduodenectomy (PD) is visual inspection, but this method is inaccurate. The hemoglobin (Hb) loss method provides a new way to evaluate blood loss during PD.
Research motivation
There was no accurate and objective way to assess blood loss in PD, and therefore, to identify the risk factors for blood loss.
Research objectives
The Hb loss method was used to analyze blood loss during PD and predict risk factors for bleeding.
Research methods
We retrospectively collected the clinical data of 341 patients who underwent PD in Shandong Provincial Hospital from March 2017 to February 2019. The differences and correlations between the intraoperative estimation of blood loss (IEBL) obtained by visual inspection and the intraoperative calculation of blood loss (ICBL) obtained using the Hb loss method were analyzed. Univariate regression analysis was performed on ICBL, IEBL, and perioperative calculation of blood loss (PCBL).
Research results
PD had an ICBL of 743.2 (393.0, 1173.1) mL and an IEBL of 100.0 (50.0, 300.0) mL (P < 0.001), but the two were also correlated (r = 0.312, P < 0.001). Single-factor analysis of ICBL showed that a history of diabetes [95% confidence interval (CI): 53.82-549.62; P = 0.017] was an independent risk factor for ICBL. In addition, the single-factor analysis of PCBL showed that body mass index (BMI) (95%CI: 0.62-76.75; P = 0.046) and preoperative total bilirubin > 200 μmol/L (95%CI: 7.09-644.26; P = 0.045) were independent risk factors for PCBL.
Research conclusions
The Hb loss method can be used to evaluate intraoperative blood loss. A history of diabetes, preoperative bilirubin > 200 μmol/L and high BMI increase the patient’s risk of bleeding.
Research perspectives
This study provides an objective measurement to evaluate blood loss during PD and thoroughly explores the risk factors for bleeding.
