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

作　　者：Yi-Min Lin Chao Yu Guo-Zhe Xian 

机构地区：[1]Department of Hepatobiliary Surgery,Shandong Provincial Hospital Affiliated to Shandong First Medical University,Jinan 250021,Shandong Province,China [2]Department of Emergency Surgery,Affiliated Hospital of Shandong University of Traditional Chinese Medicine,Jinan 250011,Shandong Province,China

出　　处：《World Journal of Gastrointestinal Surgery》2025年第3期229-239,共11页世界胃肠外科杂志(英文)

基　　金：Supported by the Shandong Provincial Natural Science Foundation General Project,No.ZR2020MH248.

摘　　要：BACKGROUND Objective and accurate assessment of blood loss during pancreaticoduodenectomy(PD)is crucial for ensuring the safety and efficacy of the procedure.While the visual method remains the most common clinical metric,many scholars argue that it significantly differs from actual blood loss and is inherently subjective.AIM To assess blood loss in PD via delta hemoglobin(ΔHb)and compare it with the visual method to predict bleeding-related risk factors.METHODS In this retrospective analysis,1722 patients who underwent PD from 2017 to 2022 at Shandong Provincial Hospital were divided into three groups:Open PD(OPD),laparoscopic PD(LPD),and conversion to OPD(CTOPD).IntraoperativeΔHb(IΔHb)was calculated via preoperative and 72-hour-postoperative hemoglobin concentrations,and its association with visually obtained estimated blood loss(EBL)was analyzed.PerioperativeΔHb(PΔHb)was calculated via preoperative and predischarge hemoglobin concentrations.We compared the differences in IΔHb and PΔHb among the three groups,and performed univariate and multi-variate regression analyses of IΔHb and PΔHb.RESULTS The preoperative general information of patients showed no statistically si-gnificant difference among the three groups(P>0.05).The IΔHb in the OPD,LPD,and CTOPD groups were 22.00(12.00,36.00),21.00(10.00,33.00),and 33.00(18.12,52.24)g/L,respectively;And the PΔHb in the OPD,LPD,and CTOPD groups were 25.87(13.51,42.00),25.00(14.00,45.00),and 37.48(21.64,59.65)g/L,respectively,values significantly differed(P<0.05).IΔHb and EBL were significantly correlated(r=0.337,P<0.001).The results of univariate and multivariate regression analyses indicated that American Society of Anesthesiologists(ASA)classification IV[95%confidence interval(CI):2.330-37.811,P=0.049]and preoperative total bilirubin>200μmol/L(95%CI:2.805-8.673,P<0.001)were independent risk factors for IΔHb(P<0.05),and ASA classification IV(95%CI:45.934-105.485,P<0.001),body mass index>24 kg/m2(95%CI:1.285-9.890,P=0.011),and preoperative total bilirubin>2

关 键 词：PANCREATICODUODENECTOMY Delta hemoglobin Estimated blood loss Postpancreatectomy hemorrhage Risk factor 

分 类 号：R73[医药卫生—肿瘤]