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    Evaluation of factors related to postoperative mortality in patients who underwent pancreatoduodenectomy due to periampullary region tumors
    (2020) Arikan, Bahadir; Sozuer, Erdogan Mutevelli; Topal, Ugur; Dal, Fatih; Bozkurt, Gamze Kubra
    Aim: In this study, we aimed to investigate the factors related to postoperative mortality after pancreatoduodenectomy in our clinic.Materials and Methods: Patients who underwent pancreatoduodenectomy due to a periampullary region tumor between 2010 and 2019 were included in the study. Mortality that occurred within 30 days after PD was defined as postoperative mortality and groups were formed according to this definition Group 1(Postoperative Mortality) and Group 2(No mortality). The demographic and clinical features, laboratory parameters, and tumor features of the patients were compared between the groups. Risk factors for mortality were analyzed by univariate analysis and multivariate logistic regression analysis.Results: 155 patients participated in our study. We found our postoperative mortality rate as 11.6%. Accordingly, Group 1 consisted of 18 and Group 2 consisted of 137 patients. The sex was similar (p: 0.235). The average age was higher in Group 1 than 2 (71.2 vs 63.7, p:0.013). Tumor localizations were similar in groups (p:0.275). Lymph node positivity was similar in the groups (50% vs 41.6%, p:0.333). The pancreatic fistula was higher in Group 1, but not statistically significant (33% vs 18.2%, p:0.119). Preoperative white blood cell count (9490 mm3 vs 8050 mm3) and neutrophil count (6898 mm3 vs5442 mm3) were higher in Group 1. In multivariate analysis, no parameters were single-handedly risk factors. Conclusion: No factor was found to be effective alone in the development of mortality after pancreaticoduodenectomy. We think that postoperative mortality may decrease by revealing the factors in the preoperative, intraoperative and postoperative periods.
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    The value and prognostic significance of neutrophil / lymphocyte ratio in predicting pancreatic fistula in patients undergoing pancreaticoduodenectomy for periampullary tumors
    (2020) Arikan, Turkmen Bahadir; Sozuer, Erdogan Mutevelli; Topal, Ugur; Dal, Fatih; Bozkurt, Gamze Kubra
    Aim: In this study, we aimed to determine the clinical value and prognostic significance of neutrophil / lymphocyte ratio in predicting pancreatic fistula in patients who underwent pancreatoduodenectomy due to periampullary tumor.Material and Methods: Patients who underwent pancreatoduodenectomy for periampullary tumor between 2010-2019 were included in the study. Group 1 (LowNLR) and Group 2 (HighNLR) were formed. Demographic and clinical characteristics, intraoperative and postoperative outcomes, and mean survival were compared between the groups. The significance of NLR in predicting pancreatic fistula at the cut off value was examined.Results: Patients were divided into two groups according to the 3.15 cut off value. Group 1 consisted of 61 patients and Group 2 consisted of 62 patients. In Group 2, albumin gr/dl value was lower (3.25 vs 3.70, p:000). in Group 2 pancreas tumors were more common (59.7% vs 42.6%, p: 0.041). The number of metastatic lymph nodes was higher in Group 1 (1.21 vs 0.63, p: 0.043), and the postoperative pancreatic fistula rate was similar (14.8% vs 21%, p: 0.254). Postoperative complications were higher in Group 2 (41.9% vs 14.8%, p: 0.032) NLR predicted pancreatic fistula with a sensitivity of 31.8% and specificity of 86.4%. In multivariate analysis, we found NLR to be a risk factor for survival (HR 1.760, 95% CI,1.179-2.627; p:0.006).Conclusion: Patients with a preoperative high NLR have a worse prognosis than patients with low NLR. It cannot be used alone to predict pancreatic fistula. NLR has the potential to be used in the management of patients.