Effect of thymosin a1 on complications after laparoscopic pancreaticoduodenectomy in elderly patients

Ying LI; Ping LIANG

doi:10.3969/j.issn.1001-5256.2021.08.028

Volume 37 Issue 8

Aug. 2021

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Effect of thymosin a1 on complications after laparoscopic pancreaticoduodenectomy in elderly patients

DOI: 10.3969/j.issn.1001-5256.2021.08.028

Ying LI^,,
Ping LIANG

Department of Hepatobiliary Surgery, The Second Affiliated Hospital of Army Medical University, PLA, Chongqing 400036, China

Received Date: 2020-12-29
Accepted Date: 2021-03-04
Published Date: 2021-08-20

Abstract

Abstract

Objective To investigate the association between perioperative immune status and postoperative infectious complications in elderly patients undergoing laparoscopic pancreaticoduodenectomy (LPD), as well as the effect of thymosin a1 on postoperative complications. Methods Related clinical data were collected from 43 elderly patients, aged 66-83 years, who underwent LPD in The Second Affiliated Hospital of Army Medical University, PLA from June 2014 to June 2018, and the patients were divided into combination group with 22 patients (with the application of thymosin a1 in the perioperative period) and control group with 21 patients (without the application of thymosin a1). Immune function parameters were observed before surgery and on days 3 and 7 after surgery, including serum levels of IgG, IgA, and IgM, peripheral blood neutrophil-lymphocyte ratio (NLR), changes in CD3⁺, CD4⁺, CD8⁺, and CD4⁺/CD8⁺ ratio, and the incidence rate of postoperative infectious complications (pulmonary infection, pancreatic leakage, and abdominal infection). In addition, the serum levels of C-reactive protein, interleukin-2 (IL-2), interleukin-10 (IL-10), tumor necrosis factor-α, and interferon-γ (IFN-γ) were measured before surgery and on days 3 and 7 after surgery. The t-test was used for comparison of continuous data between two groups; a repeated measures analysis of variance was used for comparison within each group at different time points, and the Duncan's new multiple range test was used for further pairwise comparison. The chi-square test was used for comparison of categorical data between groups. Results Compared with the control group on days 3 and 7 after surgery, the combination group had significantly higher serum levels of IgG, IgA, IgM, CD3⁺, CD4⁺, CD8⁺, and CD4⁺/CD8⁺ ratio (all P < 0.05) and a significantly lower NLR (P < 0.05). From admission to day 7 after surgery, the control group had significant reductions in the serum levels of IgG, IgA, IgM, CD3⁺, CD4⁺, CD8⁺, and CD4⁺/CD8⁺ ratio (all P < 0.05) and a significant increase in NLR (P < 0.05). The combination group had significantly lower incidence rates of postoperative pulmonary infection and abdominal infection than the control group (χ²=1.44, 1.65, all P < 0.05). Compared with the control group on days 3 and 7 after surgery, the combination group had significant increases in the serum levels of IL-2, IL-10, and IFN-γ (all P < 0.05). Conclusion Surgical trauma can further reduce the immune function of elderly patients, and the use of thymosin a1 during the perioperative period can enhance the immune function of patients and reduce the incidence rate of postoperative infectious complications.
- Pancreaticoduodenectomy,
- Aged,
- Perioperative Period,
- Postoperative Complications

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Effect of thymosin a1 on complications after laparoscopic pancreaticoduodenectomy in elderly patients

DOI: 10.3969/j.issn.1001-5256.2021.08.028

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