Abstract：
BACKGROUND: Bile duct injury (BDI) repair surgery is usually associated with morbidity/mortality. The neutrophil-to-lymphocyte ratio (NLR) easily assesses a patient\'s inflammatory status. The study aims to determine the possible relationship between preoperative NLR (pNLR) with postoperative outcomes in BDI repair surgery.
METHODS: Approved Ethics/Research Committee retrospective study, in patients who had a Bismuth-Strasberg type E BDI repair (2008-2023). Data registered was: morbidity, mortality, and long-term outcomes (primary patency and loss of primary patency) (Kaplan-Meier). Group comparison (U Mann-Whitney), receiver operator characteristic (ROC): area under curve [AUC]; cut-off value, and Youden index [J], and logistic regression analysis were used for pNLR evaluation.
RESULTS: Seventy-three patients were studied. Mean age was 44.4 years. E2 was the commonest BDI (38.4%). Perioperative morbidity/mortality was 31.5% and 1.4%. Primary patency was 95.9%. 8.2% have lost primary patency (3-year actuarial patency: 85.3%). Median pNLR was higher in patients who had any complication (4.84 vs. 2.89 p = 0.015), biliary complications (5.29 vs. 2.86 p = 0.01), and patients with loss of primary patency (5.22 vs. 3.1 p = 0.08). AUC\'s, cut-off values and (J) were: any complication (0.678, pNLR = 4.3, J = 0.38, p = 0.007), serious complication (0.667, pNLR = 4.3, J = 0.34, p = 0.04), biliary complications (0.712, pNLR = 3.64, J = 0.46, p = 0.001), and loss of primary patency (0.716, pNLR = 3.24, J = 0.52, p = 0.008). Logistic regression was significant in any complication (Exp [B]: 0.1, p = 0.002), serious complications (Exp [B]: 0.2, p = 0.03), and biliary complications (Exp [B]: 8.1, p = 0.003).
CONCLUSIONS: pNLR is associated with complications in BDI repair with moderate to acceptable predictive capacity. pNLR could potentially predict patency of a BDI repair.
METHODS: Approved Ethics/Research Committee retrospective study, in patients who had a Bismuth-Strasberg type E BDI repair (2008-2023). Data registered was: morbidity, mortality, and long-term outcomes (primary patency and loss of primary patency) (Kaplan-Meier). Group comparison (U Mann-Whitney), receiver operator characteristic (ROC): area under curve [AUC]; cut-off value, and Youden index [J], and logistic regression analysis were used for pNLR evaluation.
RESULTS: Seventy-three patients were studied. Mean age was 44.4 years. E2 was the commonest BDI (38.4%). Perioperative morbidity/mortality was 31.5% and 1.4%. Primary patency was 95.9%. 8.2% have lost primary patency (3-year actuarial patency: 85.3%). Median pNLR was higher in patients who had any complication (4.84 vs. 2.89 p = 0.015), biliary complications (5.29 vs. 2.86 p = 0.01), and patients with loss of primary patency (5.22 vs. 3.1 p = 0.08). AUC\'s, cut-off values and (J) were: any complication (0.678, pNLR = 4.3, J = 0.38, p = 0.007), serious complication (0.667, pNLR = 4.3, J = 0.34, p = 0.04), biliary complications (0.712, pNLR = 3.64, J = 0.46, p = 0.001), and loss of primary patency (0.716, pNLR = 3.24, J = 0.52, p = 0.008). Logistic regression was significant in any complication (Exp [B]: 0.1, p = 0.002), serious complications (Exp [B]: 0.2, p = 0.03), and biliary complications (Exp [B]: 8.1, p = 0.003).
CONCLUSIONS: pNLR is associated with complications in BDI repair with moderate to acceptable predictive capacity. pNLR could potentially predict patency of a BDI repair.
摘要：
背景：胆管损伤（BDI）修复手术通常与发病率/死亡率相关。中性粒细胞与淋巴细胞比率（NLR）可轻松评估患者的炎症状态。该研究旨在确定术前NLR（pNLR）与BDI修复手术术后结果之间的可能关系。
方法：批准的伦理学/研究委员会回顾性研究，在接受Bismuth-StrasbergE型BDI修复（2008-2023）的患者中。登记的数据是：发病率，死亡率,和长期结局（原发性通畅性和原发性通畅性丧失）（Kaplan-Meier）。群体比较（UMann-Whitney），受试者操作特征（ROC）：曲线下面积[AUC]；临界值，和尤登指数[J]，和logistic回归分析用于pNLR评估。
结果：研究了73例患者。平均年龄为44.4岁。E2是最常见的BDI（38.4％）。围手术期发病率/死亡率分别为31.5%和1.4%。原发性通畅率为95.9%。8.2％的人失去了主要通畅性（3年精算通畅性：85.3％）。有任何并发症的患者pNLR中位数较高（4.84vs.2.89p=0.015)，胆道并发症（5.29vs.2.86p=0.01)，和原发性通畅性丧失的患者(5.22vs.3.1p=0.08)。AUC\'s,临界值和（J）是：任何并发症（0.678，pNLR=4.3，J=0.38，p=0.007），严重并发症(0.667,pNLR=4.3,J=0.34,p=0.04),胆道并发症（0.712，pNLR=3.64，J=0.46，p=0.001），和原发性通畅性丧失（0.716，pNLR=3.24，J=0.52，p=0.008）。Logistic回归对任何并发症都有显著意义(Exp[B]:0.1,p=0.002),严重并发症（实验[B]：0.2，p=0.03），和胆道并发症（Exp[B]：8.1，p=0.003）。
结论：pNLR与BDI修复并发症相关，具有中等至可接受的预测能力。pNLR可能预测BDI修复的通畅性。
方法：批准的伦理学/研究委员会回顾性研究，在接受Bismuth-StrasbergE型BDI修复（2008-2023）的患者中。登记的数据是：发病率，死亡率,和长期结局（原发性通畅性和原发性通畅性丧失）（Kaplan-Meier）。群体比较（UMann-Whitney），受试者操作特征（ROC）：曲线下面积[AUC]；临界值，和尤登指数[J]，和logistic回归分析用于pNLR评估。
结果：研究了73例患者。平均年龄为44.4岁。E2是最常见的BDI（38.4％）。围手术期发病率/死亡率分别为31.5%和1.4%。原发性通畅率为95.9%。8.2％的人失去了主要通畅性（3年精算通畅性：85.3％）。有任何并发症的患者pNLR中位数较高（4.84vs.2.89p=0.015)，胆道并发症（5.29vs.2.86p=0.01)，和原发性通畅性丧失的患者(5.22vs.3.1p=0.08)。AUC\'s,临界值和（J）是：任何并发症（0.678，pNLR=4.3，J=0.38，p=0.007），严重并发症(0.667,pNLR=4.3,J=0.34,p=0.04),胆道并发症（0.712，pNLR=3.64，J=0.46，p=0.001），和原发性通畅性丧失（0.716，pNLR=3.24，J=0.52，p=0.008）。Logistic回归对任何并发症都有显著意义(Exp[B]:0.1,p=0.002),严重并发症（实验[B]：0.2，p=0.03），和胆道并发症（Exp[B]：8.1，p=0.003）。
结论：pNLR与BDI修复并发症相关，具有中等至可接受的预测能力。pNLR可能预测BDI修复的通畅性。
