Published online Feb 27, 2024. doi: 10.4240/wjgs.v16.i2.419
Peer-review started: September 24, 2023
First decision: December 14, 2023
Revised: December 26, 2023
Accepted: January 19, 2024
Article in press: January 19, 2024
Published online: February 27, 2024
The most common way to evaluate blood loss during pancreaticoduodenectomy (PD) is visual inspection, but this me
There was no accurate and objective way to assess blood loss in PD, and therefore, to identify the risk factors for blood loss.
The Hb loss method was used to analyze blood loss during PD and predict risk factors for bleeding.
We retrospectively collected the clinical data of 341 patients who underwent PD in Shandong Provincial Hospital from March 2017 to February 2019. The differences and correlations between the intraoperative estimation of blood loss (IEBL) obtained by visual inspection and the intraoperative calculation of blood loss (ICBL) obtained using the Hb loss method were analyzed. Univariate regression analysis was performed on ICBL, IEBL, and perioperative calculation of blood loss (PCBL).
PD had an ICBL of 743.2 (393.0, 1173.1) mL and an IEBL of 100.0 (50.0, 300.0) mL (P < 0.001), but the two were also correlated (r = 0.312, P < 0.001). Single-factor analysis of ICBL showed that a history of diabetes [95% confidence interval (CI): 53.82-549.62; P = 0.017] was an independent risk factor for ICBL. In addition, the single-factor analysis of PCBL showed that body mass index (BMI) (95%CI: 0.62-76.75; P = 0.046) and preoperative total bilirubin > 200 μmol/L (95%CI: 7.09-644.26; P = 0.045) were independent risk factors for PCBL.
The Hb loss method can be used to evaluate intraoperative blood loss. A history of diabetes, preoperative bilirubin > 200 μmol/L and high BMI increase the patient’s risk of bleeding.
This study provides an objective measurement to evaluate blood loss during PD and thoroughly explores the risk factors for bleeding.