Preprint Article Version 1 Preserved in Portico This version is not peer-reviewed

The Role of Albumin-Globulin Ratio on Predicting Postoperative Pancreatic Fistula in Pancreaticoduodenectomy Patients

Version 1 : Received: 20 March 2022 / Approved: 25 March 2022 / Online: 25 March 2022 (09:00:37 CET)

How to cite: Ciftci, A.B.; Yemez, K.; Eraslan, H. The Role of Albumin-Globulin Ratio on Predicting Postoperative Pancreatic Fistula in Pancreaticoduodenectomy Patients. Preprints 2022, 2022030342. https://doi.org/10.20944/preprints202203.0342.v1 Ciftci, A.B.; Yemez, K.; Eraslan, H. The Role of Albumin-Globulin Ratio on Predicting Postoperative Pancreatic Fistula in Pancreaticoduodenectomy Patients. Preprints 2022, 2022030342. https://doi.org/10.20944/preprints202203.0342.v1

Abstract

Background and aim: The albumin-globulin ratio (AGR) is one of the indicators of inflammation and immunity and it has a prognostic significance in many malignant diseases. Previous studies have shown the relationship between inflammatory mediators and POPF. This study aimed to evaluate the relation of AGR, which is a relatively new indicator, with postoperative pancreatic fistula (POPF). Methods: Pancreaticoduodenectomy (PD) patients between 2017 and 2020 were retrospectively analyzed and divided into two groups as those with and without clinically relevant POPF (CR-POPF). They were compared in terms of preoperative-postoperative AGR and clinicodemographic characteristics. AGR was calculated as Albumin / (Total protein-albumin) and the cutoff point for AGR was determined according to Youden’s index. Results: CR-POPF developed in 21% of 121 patients who underwent PD. There was no difference between the groups in terms of age, gender, comorbid disease status, pancreatic duct width, and anastomosis technique. Preoperative and postoperative day-3 (POD3) albumin levels and AGR were found to be significantly lower in the CR-POPF group. Multivariate analysis showed that AGR and pancreatic tissue stiffness are independent risk factors for the development of POPF. Conclusions: Low AGR is an independent risk factor for the development of CR-POPF. To reduce the incidence of POPF, this ratio should be tried to be kept at an optimal level.

Supplementary and Associated Material

Keywords

albumin-globulin ratio; postoperative pancreatic fistula; pancreaticoduodenectomy

Subject

Medicine and Pharmacology, Immunology and Allergy

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