Preoperative neutrophil-to-lymphocyte ratio predicts healing time for postoperative pancreatic fistula after distal pancreatectomy

Purpose Postoperative pancreatic fistula is a serious complication of distal pancreatectomy. Although many studies have described the incidence and risk factors associated with postoperative pancreatic fistula (POPF), few have focused on the healing time. This study investigated the healing time and potential factors associated with the healing time of POPF after distal pancreatectomy (DP). Methods Among 114 patients that underwent DP in our hospital from January 2010 to December 2020, we included 88 that developed POPF. The healing time for a postoperative pancreatic fistula was defined as the interval between the completion of DP and the removal of all drains related to the treatment for POPF. Based on the definition, three cases who required additional treatment after removal of all drains were excluded from this study. Clinical factors associated with the fistula healing times were investigated in the 85 patients. Results The average POPF healing time was 11 +/- 10 days (median: 6 days, range: 3-57). We found that the neutrophil-to-lymphocyte ratio, a marker of inflammatory and nutritional status, was the only factor independently associated with the POPF healing time; the mean healing time was significantly shorter in patients with neutrophil-to-lymphocyte ratio <= 2.1 (8 +/- 6 days) than in those with neutrophil-to-lymphocyte ratio >2.1 (13 +/- 12 days; P = .0139). Conclusion We demonstrated that the neutrophil-to-lymphocyte ratio could independently predict the POPF healing time after DP. These findings suggested that improving the neutrophil-to-lymphocyte ratio might shorten the healing times for POPF after DP.

Automated summary

This study investigated the healing time and potential factors associated with the healing time of postoperative pancreatic fistula (POPF) after distal pancreatectomy (DP). The study found that the neutrophil-to-lymphocyte ratio was the only factor independently associated with the healing time of POPF. Patients with a lower neutrophil-to-lymphocyte ratio had significantly shorter healing times for POPF after DP.