The Short-term Influence Of Body Mass Index On Patients Undergoing Laparoscopic Pancreatoduodenectomy:A Single-Center Propensity Score Matching Study

Background:The complications after laparoscopic pancreatoduodenectomy(LPD)seriously affect the short-term prognosis of patients.By analyzing the shortterm influence of body mass index(BMI)on patients undergoing LPD,this study provides some clinical experience for perioperative management of LPDMethod:The present study retrospectively collected clinical data of patients who underwent LPD in Shandong provincial hospital.The patients were divided into the normal-weight group(BMI<24)and overweight group(BMI≥24)according to their BMI,and a 1:1 propensity score matching(PSM)method was performed.The complications of two group were compared.Perioperative mortality was calculated and short-term survival was analyzed by Kaplan-Meier curves.Result:A total of 432 patients were identified,241 patients were normal-weight and 191 patients were overweight There were significant differences between two groups in certain characteristics,including hypertension,albumin and hemoglobin(all P<0.05).By PSM method,there were 144 patients in normal-weight group and 144 patients in overweight group,and no statistically significant differences were noted in patient characteristics.After PSM,there was no significant difference in operation time,intraoperative blood loss,intraoperative blood transfusion,and hospital stay between the normal-weight group and the overweight group(P>0.05);The incidence of Clinically relevant postoperative pancreatic fistula(B/C grade pancreatic fistula,CR-POPF)and delayed gastric emptying was significantly increased in weight group,with 26(18.1%)and 41(28.5%)cases of CR-POPF(P=0.036),respectively,and with 16(11.1%)and 31(21.5%)cases of delayed gastric emptying occurred(P=0.017),respectively.There was no significant difference among two groups in postoperative hemorrhage,bile leakage,gastrointestinal fistula,postoperative abdominal infection,Clavien-Dindo classification and secondary operation.Subgroup analysis demonstrated that between the non-obese overweight subgroup(24≤BMI<28)and the obese subgroup(BMI≥28),there was no significant difference between the two groups in terms of operation time,intraoperative blood loss,intraoperative blood transfusion,and hospital stay and postoperative complications(P>0.05).There were 3(2.1%)and 7(4.9%)perioperative deaths among the normal group and the overweight group,respectively(P=0.198),and there were 57(39.6%)and 46(31.9%)cases of lost respectively.The 3-month,6-month and 1-year survival rates in the normal-weight group were 92.0%,87.4%and 86.1%respectively,and rates in overweight group were 88.8%,85.7%and 83.6%respectively(P=0.635).Conclusion:The incidence of CR-POPF and delayed gastric emptying of LPD in overweight patients was higher than that in normal-weight patients.The perioperative mortality and short-term survival rate of overweight patients were not significantly different from those of normal-weight patients.