Hypoalbuminemia after pancreaticoduodenectomy does not predict or affect short-term postoperative prognosis

Abstract

Background: Hypoalbuminemia (HA) is a risk factor for the complications following pancreaticoduodenectomy (PD). This study aimed to explore the factors that affect HA following PD and evaluate the influence of HA on the short-term postoperative prognosis. Methods: Total 163 patients who underwent PD and met inclusion criteria were subdivided into two groups according to the status of HA. The relationships of postoperative albumin (ALB) level and exogenous ALB infusion with postoperative responses and complications were assessed by correlation analysis. Results: Preoperative ALB ≥35.0 g/L and postoperative complication grade were factors influencing HA after PD. Correlation analysis demonstrated significant negative correlation of postoperative ALB level with white blood cell (WBC) count and neutrophil count. Postoperative exogenous ALB infusion positively correlated with blood urea nitrogen, creatinine, complication grade, postoperative intraperitoneal hemorrhage and pancreatic fistula. No significant differences were observed between the complications and30-day mortality rates with and without postoperative HA. Conclusions: HA after PD should not be considered as an indicator but rather a result of poor prognosis. WBCs, especially neutrophils, are involved in reducing postoperative ALB level. Infusion of exogenous ALB to maintain ALB > 30 g/L could not improve clinical outcomes.