Gustavo Martinez-Mier MD, FACS, Regina Carbajal-Hernández MD, Mario López-García MD, Jorge A. Vázquez-Ramirez MD, José M. Reyes-Ruiz PhD, Jose R. Solórzano-Rubio MD, José L. González-Grajeda MD, Pedro I. Moreno-Ley MD
{"title":"中性粒细胞与淋巴细胞比率可预测胆管损伤修复的并发症和通畅性。","authors":"Gustavo Martinez-Mier MD, FACS, Regina Carbajal-Hernández MD, Mario López-García MD, Jorge A. Vázquez-Ramirez MD, José M. Reyes-Ruiz PhD, Jose R. Solórzano-Rubio MD, José L. González-Grajeda MD, Pedro I. Moreno-Ley MD","doi":"10.1111/ans.19104","DOIUrl":null,"url":null,"abstract":"<div>\n \n \n <section>\n \n <h3> Background</h3>\n \n <p>Bile duct injury (BDI) repair surgery is usually associated with morbidity/mortality. The neutrophil-to-lymphocyte ratio (NLR) easily assesses a patient's inflammatory status. The study aims to determine the possible relationship between preoperative NLR (<i>p</i>NLR) with postoperative outcomes in BDI repair surgery.</p>\n </section>\n \n <section>\n \n <h3> Methods</h3>\n \n <p>Approved Ethics/Research Committee retrospective study, in patients who had a Bismuth-Strasberg type E BDI repair (2008–2023). Data registered was: morbidity, mortality, and long-term outcomes (primary patency and loss of primary patency) (Kaplan–Meier). Group comparison (<i>U</i> Mann–Whitney), receiver operator characteristic (ROC): area under curve [AUC]; cut-off value, and Youden index [J], and logistic regression analysis were used for <i>p</i>NLR evaluation.</p>\n </section>\n \n <section>\n \n <h3> Results</h3>\n \n <p>Seventy-three patients were studied. Mean age was 44.4 years. E2 was the commonest BDI (38.4%). Perioperative morbidity/mortality was 31.5% and 1.4%. Primary patency was 95.9%. 8.2% have lost primary patency (3-year actuarial patency: 85.3%). Median <i>p</i>NLR was higher in patients who had any complication (4.84 <i>vs.</i> 2.89 <i>p</i> = 0.015), biliary complications (5.29 <i>vs.</i> 2.86 <i>p</i> = 0.01), and patients with loss of primary patency (5.22 <i>vs.</i> 3.1 <i>p</i> = 0.08). AUC's, cut-off values and (J) were: any complication (0.678, <i>p</i>NLR = 4.3, <i>J</i> = 0.38, <i>p</i> = 0.007), serious complication (0.667, <i>p</i>NLR = 4.3, <i>J</i> = 0.34, <i>p</i> = 0.04), biliary complications (0.712, <i>p</i>NLR = 3.64, <i>J</i> = 0.46, <i>p</i> = 0.001), and loss of primary patency (0.716, <i>p</i>NLR = 3.24, <i>J</i> = 0.52, <i>p</i> = 0.008). Logistic regression was significant in any complication (Exp [B]: 0.1, <i>p</i> = 0.002), serious complications (Exp [B]: 0.2, <i>p</i> = 0.03), and biliary complications (Exp [B]: 8.1, <i>p</i> = 0.003).</p>\n </section>\n \n <section>\n \n <h3> Conclusions</h3>\n \n <p><i>p</i>NLR is associated with complications in BDI repair with moderate to acceptable predictive capacity. <i>p</i>NLR could potentially predict patency of a BDI repair.</p>\n </section>\n </div>","PeriodicalId":8158,"journal":{"name":"ANZ Journal of Surgery","volume":null,"pages":null},"PeriodicalIF":1.5000,"publicationDate":"2024-07-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Neutrophil-to-lymphocyte ratio may predict complications and patency in bile duct injury repair\",\"authors\":\"Gustavo Martinez-Mier MD, FACS, Regina Carbajal-Hernández MD, Mario López-García MD, Jorge A. Vázquez-Ramirez MD, José M. Reyes-Ruiz PhD, Jose R. Solórzano-Rubio MD, José L. González-Grajeda MD, Pedro I. Moreno-Ley MD\",\"doi\":\"10.1111/ans.19104\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<div>\\n \\n \\n <section>\\n \\n <h3> Background</h3>\\n \\n <p>Bile duct injury (BDI) repair surgery is usually associated with morbidity/mortality. The neutrophil-to-lymphocyte ratio (NLR) easily assesses a patient's inflammatory status. The study aims to determine the possible relationship between preoperative NLR (<i>p</i>NLR) with postoperative outcomes in BDI repair surgery.</p>\\n </section>\\n \\n <section>\\n \\n <h3> Methods</h3>\\n \\n <p>Approved Ethics/Research Committee retrospective study, in patients who had a Bismuth-Strasberg type E BDI repair (2008–2023). Data registered was: morbidity, mortality, and long-term outcomes (primary patency and loss of primary patency) (Kaplan–Meier). Group comparison (<i>U</i> Mann–Whitney), receiver operator characteristic (ROC): area under curve [AUC]; cut-off value, and Youden index [J], and logistic regression analysis were used for <i>p</i>NLR evaluation.</p>\\n </section>\\n \\n <section>\\n \\n <h3> Results</h3>\\n \\n <p>Seventy-three patients were studied. Mean age was 44.4 years. E2 was the commonest BDI (38.4%). Perioperative morbidity/mortality was 31.5% and 1.4%. Primary patency was 95.9%. 8.2% have lost primary patency (3-year actuarial patency: 85.3%). Median <i>p</i>NLR was higher in patients who had any complication (4.84 <i>vs.</i> 2.89 <i>p</i> = 0.015), biliary complications (5.29 <i>vs.</i> 2.86 <i>p</i> = 0.01), and patients with loss of primary patency (5.22 <i>vs.</i> 3.1 <i>p</i> = 0.08). AUC's, cut-off values and (J) were: any complication (0.678, <i>p</i>NLR = 4.3, <i>J</i> = 0.38, <i>p</i> = 0.007), serious complication (0.667, <i>p</i>NLR = 4.3, <i>J</i> = 0.34, <i>p</i> = 0.04), biliary complications (0.712, <i>p</i>NLR = 3.64, <i>J</i> = 0.46, <i>p</i> = 0.001), and loss of primary patency (0.716, <i>p</i>NLR = 3.24, <i>J</i> = 0.52, <i>p</i> = 0.008). Logistic regression was significant in any complication (Exp [B]: 0.1, <i>p</i> = 0.002), serious complications (Exp [B]: 0.2, <i>p</i> = 0.03), and biliary complications (Exp [B]: 8.1, <i>p</i> = 0.003).</p>\\n </section>\\n \\n <section>\\n \\n <h3> Conclusions</h3>\\n \\n <p><i>p</i>NLR is associated with complications in BDI repair with moderate to acceptable predictive capacity. <i>p</i>NLR could potentially predict patency of a BDI repair.</p>\\n </section>\\n </div>\",\"PeriodicalId\":8158,\"journal\":{\"name\":\"ANZ Journal of Surgery\",\"volume\":null,\"pages\":null},\"PeriodicalIF\":1.5000,\"publicationDate\":\"2024-07-26\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"ANZ Journal of Surgery\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://onlinelibrary.wiley.com/doi/10.1111/ans.19104\",\"RegionNum\":4,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q3\",\"JCRName\":\"SURGERY\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"ANZ Journal of Surgery","FirstCategoryId":"3","ListUrlMain":"https://onlinelibrary.wiley.com/doi/10.1111/ans.19104","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q3","JCRName":"SURGERY","Score":null,"Total":0}
Neutrophil-to-lymphocyte ratio may predict complications and patency in bile duct injury repair
Background
Bile duct injury (BDI) repair surgery is usually associated with morbidity/mortality. The neutrophil-to-lymphocyte ratio (NLR) easily assesses a patient's inflammatory status. The study aims to determine the possible relationship between preoperative NLR (pNLR) with postoperative outcomes in BDI repair surgery.
Methods
Approved Ethics/Research Committee retrospective study, in patients who had a Bismuth-Strasberg type E BDI repair (2008–2023). Data registered was: morbidity, mortality, and long-term outcomes (primary patency and loss of primary patency) (Kaplan–Meier). Group comparison (U Mann–Whitney), receiver operator characteristic (ROC): area under curve [AUC]; cut-off value, and Youden index [J], and logistic regression analysis were used for pNLR evaluation.
Results
Seventy-three patients were studied. Mean age was 44.4 years. E2 was the commonest BDI (38.4%). Perioperative morbidity/mortality was 31.5% and 1.4%. Primary patency was 95.9%. 8.2% have lost primary patency (3-year actuarial patency: 85.3%). Median pNLR was higher in patients who had any complication (4.84 vs. 2.89 p = 0.015), biliary complications (5.29 vs. 2.86 p = 0.01), and patients with loss of primary patency (5.22 vs. 3.1 p = 0.08). AUC's, cut-off values and (J) were: any complication (0.678, pNLR = 4.3, J = 0.38, p = 0.007), serious complication (0.667, pNLR = 4.3, J = 0.34, p = 0.04), biliary complications (0.712, pNLR = 3.64, J = 0.46, p = 0.001), and loss of primary patency (0.716, pNLR = 3.24, J = 0.52, p = 0.008). Logistic regression was significant in any complication (Exp [B]: 0.1, p = 0.002), serious complications (Exp [B]: 0.2, p = 0.03), and biliary complications (Exp [B]: 8.1, p = 0.003).
Conclusions
pNLR is associated with complications in BDI repair with moderate to acceptable predictive capacity. pNLR could potentially predict patency of a BDI repair.
期刊介绍:
ANZ Journal of Surgery is published by Wiley on behalf of the Royal Australasian College of Surgeons to provide a medium for the publication of peer-reviewed original contributions related to clinical practice and/or research in all fields of surgery and related disciplines. It also provides a programme of continuing education for surgeons. All articles are peer-reviewed by at least two researchers expert in the field of the submitted paper.