Anemia after pancreaticoduodenectomy in patients followed‐up for 5 years

• Published in: Journal of hepato-biliary-pancreatic sciences Vol. 31; no. 10; pp. 747 - 753
• Main Authors: Wu, Jin‐Ming, Kuo, Ting‐Chun, Wu, Chien‐Hui, Yang, Ching‐Yao, Tien, Yu‐Wen
• Format: Journal Article
• Language: English
• Published: Japan 01.10.2024
• Subjects: Aged; anemia; Anemia - etiology; Carcinoma, Pancreatic Ductal - surgery; Female; Follow-Up Studies; Humans; Male; Middle Aged; pancreatic cancer; Pancreatic Neoplasms - surgery; pancreaticoduodenectomy; Pancreaticoduodenectomy - adverse effects; Postoperative Complications - epidemiology; Postoperative Complications - etiology; Retrospective Studies; Risk Factors; pancreaticoduodenectomy; pancreatic cancer; anemia
• ISSN: 1868-6974; 1868-6982; 1868-6982
• DOI: 10.1002/jhbp.12058

Background Anemia is a common long‐term metabolic sequela caused by anatomical changes after major gastrointestinal surgery, such as bariatric surgery and gastrectomy. Pancreaticoduodenectomy (PD) involves resection of the duodenum and enteral bypass, which may contribute to malabsorption and nutrient deficiency. Hence, PD may cause anemia. Methods This study included 322 patients who presented with PD during the 5‐year follow‐up from 2006 to 2017. The Kaplan–Meier method and the Cox regression model were used to investigate the association between risk factors and anemia. Results Approximately 44.4% of patients developed post‐PD anemia during the 5‐year post‐PD follow‐up. Further, 30 (9.3%) patients were treated with oral iron supplementation for anemia with associated symptoms. In the Cox multivariate model, a higher Charlson Comorbidity Index (CCI) score and pancreatic ductal adenocarcinoma were significantly associated with the development of post‐PD anemia. Conclusion Post‐PD anemia is a common sequela among long‐term survivors. A higher CCI and pancreatic ductal adenocarcinoma diagnosis were considered as independent risk factors for post‐PD anemia. Therefore, regular monitoring of hematological profiles and appropriate management of post‐PD anemia are required during follow‐up. Post‐pancreaticoduodenectomy anemia is common, affecting 44.4% of patients over 5 years. Wu and colleagues revealed higher Charlson Comorbidity Index scores and pancreatic ductal adenocarcinoma to be significant independent risk factors. Regular monitoring of hematological profiles and appropriate management of anemia during follow‐up are essential for improving patient outcomes.