Effect Of Body Mass Index On The Perioperative Period Of Laparoscopic Pancreaticoduodenectomy

Objective To analyze the influence of body mass index（BMI）on perioperative period of patients undergoing laparoscopic pancreaticoduodenectomy.Methods Retrospective analysis was performed on the case data of 108 patients with LPD in the Department of Hepatobiliary Surgery,the First Affiliated Hospital of Benbu Medical College from Jan.2015 to Jan.2022.Collect gender,age,operation time,intraoperative bleeding,tumor size,tumor,biochemical indicators,tumor markers,body mass index,pancreatic texture,postoperative complications and postoperative discharge time,divided into two groups,namely non-overweight（BMI <24）and overweight（BMI≥24）,select the appropriate statistical method to explore the effect of body mass index on perioperative period.Results Compared to the non-overweight,longer operative time（min）[368.1±53.6min VS405.63±62.3min,P=0.032] and the higher incidence of soft pancreas were occurs in overweight group,28.5% and 54.5%（P=0.005）.For perioperative postoperative complications,pancreatic fistula,biliary fistula and abdominal infection had a higher incidence of 24.2%,22.2% and 15.2%,respectively,and the incidence of non-overweight recombinant pancreatic fistula,biliary fistula and abdominal infection was 4.7%,7.1% and 2.4%,significant differences existed between the two groups（P<0.05）,but no significant difference in intraoperative bleeding volume,drainage tube placement time and incidence of gastric paralysis.Furthermore,the postoperative length of stay（d）was longer in the overweight group [10.2±3.0d vs 14.4±3.5d,P=0.023].Later multivariate logistic regression analysis showed that BMI,abdominal infection and pancreatic texture were independent risk factors for pancreatic fistula（P <0.05）.Conclusion In conclusion,overweight patients may have longer surgical time for laparoscopic pancreaticoduodenectomy,greater probability of postoperative biliary fistula,pancreatic fistula and abdominal infection,and prolonged hospital stay.In conclusion,clinicians,in addition to mature and sophisticated techniques,also need to manage perioperative management during pancreaticoduodenectomy.