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©The Author(s) 2023. Published by Baishideng Publishing Group Inc. All rights reserved.
Predictive value of preoperative albumin-bilirubin score and other risk factors for short-term outcomes after open pancreatoduodenectomy
Hana Zavrtanik, Davide Cosola, David Badovinac, Benjamin Hadžialjević, Gašper Horvat, Danaja Plevel, Selene Bogoni, Paola Tarchi, Nicolò de Manzini, Aleš Tomažič
Hana Zavrtanik, David Badovinac, Benjamin Hadžialjević, Gašper Horvat, Danaja Plevel, Aleš Tomažič, Department of Abdominal Surgery, University Medical Centre Ljubljana, Ljubljana 1000, Slovenia
Davide Cosola, Selene Bogoni, Paola Tarchi, Nicolò de Manzini, Clinica Chirurgica, Azienda Sanitaria Universitaria Giuliano Isontina, Cattinara Hospital, Trieste 34149, Italy
Nicolò de Manzini, Department of Medical, Surgical and Health Sciences, University of Trieste, Trieste 34149, Italy
Aleš Tomažič, Faculty of Medicine, University of Ljubljana, Ljubljana 1000, Slovenia
Author contributions: Zavrtanik H gave substantial contributions to the conception and design of the manuscript; Zavrtanik H, Cosola D, Badovinac D, Hadžialjević B, Horvat G, Plevel D, Bogoni S, and Tarchi P contributed to the acquisition, analysis, and interpretation of the data; all authors participated in drafting the manuscript; Tomažič A and de Manzini N critically revised the manuscript for important intellectual content.
Institutional review board statement: Based on local policies, retrospective reviews of existing medical records recorded by the investigator in an anonymous manner are exempt from Institutional Review Board review and do not require its approval.
Informed consent statement: All study participants, or their legal guardian, provided informed written consent prior to study enrollment.
Conflict-of-interest statement: The authors declare no conflicts of interest for this article.
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 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: Aleš Tomažič, MD, PhD, Chief Doctor, Professor, Surgeon, Department of Abdominal Surgery, University Medical Centre Ljubljana, 7 Zaloška Cesta, Ljubljana 1000, Slovenia. ales.tomazic@kclj.si
Received: April 27, 2023
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
ARTICLE HIGHLIGHTS
Research background
Pancreatoduodenectomy remains associated with high rates of severe morbidity, even in high-volume centres.
Research motivation
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.
Research objectives
Clinical significance of the preoperative ALBI score and other risk factors in relation to short-term postoperative outcomes in patients after pancreatoduodenectomy was evaluated.
Research methods
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.
Research results
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.
Research conclusions
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.
Research perspectives
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.
