Estudo Retrospetivo Observacional de Pacientes e Outcomes Associados a Duodenopancreatectomia Cefálica

Abstract

Background: Pancreatic cancer is still one off the most aggressive cancers nowadays, and its incidence has been rising. Surgical excision is the only definite treatment and multidisciplinary centers have appeared recently; however, the morbidity rate of pancreatic cancer surgery remains high. Pancreatic cancer patients usually present with signs of malnutrition, such as weight loss and cachexia, especially in advanced stages. Malnutrition has been recognized as a major risk factor for adverse surgical outcomes. Early and appropriate nutritional interventions have managed to reduce morbidity, mortality, average length of hospital stay and associated hospitalization costs. This study aims to reassure the correlation between malnutrition and adverse surgical outcomes in patients undergoing cephalic pancreatoduodenectomy in CHUSJ. Methods: We collected and described data about 102 patients operated between 2018 and 2022. Data as body mass index, ASA Physical Status Classification System, analytical studies, length of hospital stay, mortality, diagnostic that motivated surgery and surgical complications as pancreatic fistula, hemorrhage, infection, delayed gastric emptying and suture dehiscence were analyzed. Results: Male sex presents as a risk factor to develop pancreatic fistula (p=0,026). When outcomes were analyzed by BMI subgroups, there were no significative differences, however, there was a tendency to have higher length in hospital and mortality rate on those who were overweight and obese (p=0,056 and p=0,053)). Despite what we expected, there were significative differences in length of hospital stay and occurrence of at least one complication when these variables were analyzed by albumin level, showing that patients with hypoalbuminemia stay less days in hospital and have less presence of complications (p=0,018 and p=0,023). Discussion: Nutritional state and Body Mass Index have a role as predictor factors of perioperative morbimortality and should be more broadly studied and applied on pre-operatory approach in order to achieve better results on patient management.