Distal Pankreatektomi Sonrası Pankreatik Fistül Gelişimini Tahmin Etmede İnflamatuar İndekslerin Rolü

Öz

Amaç: İnflamatuar belirteçlerin, distal pankreatektomi sonrası pankreatik fistül gelişimini tahmin etmedeki önemi, bu konuda yapılan çalışmalarla yeterince derinlemesine incelenmemiştir. Bu çalış-ma, distal pankreatektomi yapılan hastalarda postoperatif inflamatuar indekslerin, özellikle SII (siste-mik immün inflamasyon indeksi), NLR (nötrofil-lenfosit oranı) ve PLR (trombosit-lenfosit oranı), pank-reatik fistül gelişimi ile ilişkisini değerlendirmeyi amaçlamaktadır. Materyal ve Metod: Bu retrospektif çalışmada, Ocak 2020 ile Aralık 2023 arasında pankreatik kanser nedeniyle distal pankreatektomi uygulanan hastalar analiz edilmiştir. İstatistiksel analizler, pankreatik fistül (B ve C dereceleri) gelişen hastaların, üçüncü postoperatif günde elde edilen laboratuvar sonuç-larına dayalı olarak hesaplanan SII, NLR ve PLR verileri retrospektif olarak incelenerek yapılmıştır. Bulgular: Çalışmaya, belirlenen kriterlere uyan 72 hasta dahil edildi. Bu hastaların 25'inde (% 34.7) pankreatik fistül gözlemlendi. Bu çalışmada, BMI ve yumuşak pankreatik doku pankreatik fistül gelişimi için istatistiksel olarak anlamlı risk faktörleri olarak bulundu (her ikisi için p=0.02). Postoperatif üçün-cü günde ölçülen SII ve NLR, pankreatik fistül gelişiminin istatistiksel olarak anlamlı prediktörleri olurken, postoperatif PLR’nin pankreatik fistül gelişimini tahmin etmede istatiksel anlamlı sonuç vermediği görüldü. SII’nin pankreatik fistül gelişiminin tahmin edilmesinde NLR'den daha güçlü bir prediktör olduğu görüldü. Sonuç: Bu çalışma, inflamasyonla ilişkili indeksler olan SII ve NLR'deki artışın, distal pankreatektomi sonrası pankreatik fistül gelişiminin tahmin edilmesinde etkili bir yöntem olduğunu göstermektedir. Buna karşılık, PLR'nin pankreatik fistül gelişimini tahmin etmede etkili olmadığı görüldü.

Anahtar Kelimeler

• distal pankreatektomi
• pankreatik fistül
• SII
• NLR
• PLR

The Role of Inflammatory Indices in Predicting Pancreatic Fistula After Distal Pancreatectomy

Öz

Background: The significance of inflammatory markers in forecasting pancreatic fistula development has not been thoroughly investigated in patients who have undergone distal pancreatectomy. This study seeks to assess the predictive value of postoperative inflammatory indices, particularly SII (systemic immune inflammation index), NLR (neutrophil-to-lymphocyte ratio) and PLR (platelet-to-lymphocyte ratio), concerning the onset of pancreatic fistula in these patients. Materials and Methods: This retrospective study analyzed patients who underwent distal pancreatec-tomy for pancreatic cancer between January 2020 and December 2023. Statistical analyses were performed by retrospectively examining the data obtained from the prospectively filled clinical notes of patients who developed pancreatic fistula (Grade B and C) using the SII, NLR and PLR calculated based on the laboratory results obtained on the third postoperative day. Results: The study included 72 patients who fulfilled the established criteria. Pancreatic fistulas were observed in 25 (34.7%) of the patients. In this study, BMI and soft pancreatic tissue were statistically significant risk factors for pancreatic fistula development (p=0.02 for both). SII and NLR from the third postoperative day were statistically significant predictors of pancreatic fistula development, while postoperative PLR did not provide statistically significant results. SII was a more significant predictor of pancreatic fistula than NLR. Conclusions: This study conveys that monitoring the increase in SII and NLR, which are inflammation-related indices, is an effective method for predicting the development of pancreatic fistula after distal pancreatectomy, whereas PLR is not effective in predicting the development of pancreatic fistula.

Anahtar Kelimeler

• distal pancreatectomy
• pancreatic fistula
• SII
• NLR
• PLR

Kaynakça

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