Mean Post-Operative C -Reactive Protein to Albumin Ratio Among the Patient undergoing Pancreaticoduodenectomy in a Tertiary Care Hospital
DOI:
https://doi.org/10.56974/pmjn.898Keywords:
C-reactive protein to albumin ratio, clinically relevant post-operative pancreatic fistula, pancreaticoduodenectomyAbstract
Introduction: Assessment of third post-operative day C-reactive protein to albumin ratio in patients with post-operative Pancreatic fistula would help surgeons avoid shortcomings of drain amylase, which is liable to be affected by the drainage tube’s location or condition. This could be a novel inflammatory marker when surgeons are practicing drainless surgery following Pancreaticoduodenectomy. Predicting Clinically Relevant Post-Operative Pancreatic Fistula would help to manage post-operative morbidities associated with Pancreaticoduodenectomy. The main aim of the study was to determine mean post-operative c -reactive protein to albumin ratio among the patient undergoing pancreaticoduodenectomy in a tertiary care hospital.
Methods: This cross sectional was done in patients undergoing Pancreaticoduodenectomy for malignant pancreatic head and periampullary pathology at Department of Gastroenterology, NAMS, Bir Hospital from May 2024 to May 2025. All the variables were recorded in the preformed proforma and C -Reactive Protein to Albumin Ratio was computed by dividing third Post-operative Day C-reactive protein by third post operative serum albumin. Data was analyzed using MS Excel 365 & SPSS version 27.
Results: The overall mean C -Reactive Protein to Albumin Ratio was 6.29 ± 3.24 (5.33 to 7.25 at 95% Confidence Interval. A total of 44 patients, with 28 (63.63%) males and 16 (36.36 %) females. Among these, 20 (45.45%) patients underwent preoperative biliary drainage, 5 (11.36%) had Percutaneous transhepatic biliary drainage and 15 (34.09%) had Endoscopic Retrograde Cholangio Pancreaticography and stenting. The commonest pathology was ampullary carcinoma,16 (36.36%) and pancreatic ductal adenocarcinoma,16 (36.36%) followed by distal cholangiocarcinoma,10 (22.72%) and duodenal adenocarcinoma, 2 (4.54%).
Conclusions: Our results showed that patients with high third POD C -Reactive Protein to Albumin Ratio had Clinically Relevant Post-Operative Pancreatic Fistula. This was similar to study conducted by Sakamoto et al and Heard et al. Comparative studies of C -Reactive Protein to Albumin Ratiowith other inflammatory markers could be done to see their association with Post-Operative Pancreatic Fistula.
