Correlation Between Systemic Inflammation, Gut Microbiome Dysbiosis and Postoperative Complications After the Modified Whipple Procedure
(1) Background: The modified Whipple procedure, or pylorus-preserving pancreaticoduodenectomy, is a complex surgical intervention used to treat pancreatic head tumors. While preserving digestive function, it is associated with significant perioperative risks. This study explores the clinical, immuno...
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2025-01-01
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| author | Gelu Mihai Breaza Florin Emil Hut Octavian Cretu Simona-Alina Abu-Awwad Ahmed Abu-Awwad Laurențiu Vasile Sima Radu Gheorghe Dan Cristina Ana-Maria Dan Raluca Maria Closca Flavia Zara |
| author_facet | Gelu Mihai Breaza Florin Emil Hut Octavian Cretu Simona-Alina Abu-Awwad Ahmed Abu-Awwad Laurențiu Vasile Sima Radu Gheorghe Dan Cristina Ana-Maria Dan Raluca Maria Closca Flavia Zara |
| author_sort | Gelu Mihai Breaza |
| collection | DOAJ |
| description | (1) Background: The modified Whipple procedure, or pylorus-preserving pancreaticoduodenectomy, is a complex surgical intervention used to treat pancreatic head tumors. While preserving digestive function, it is associated with significant perioperative risks. This study explores the clinical, immunological, and microbiome-related factors influencing postoperative complications, focusing on the interplay between patient comorbidities, systemic inflammation, and gut dysbiosis. (2) Methods: A retrospective analysis was conducted on 123 patients undergoing the modified Whipple procedure for pancreatic head tumors. Patients were categorized into two groups based on the occurrence of significant postoperative complications (Group A: with complications; Group B: without complications). Data on demographics, comorbidities, inflammatory markers (CRP, IL-6, procalcitonin), and gut microbiome composition were collected. Microbial diversity was evaluated using the Shannon Index, and logistic regression was performed to identify independent predictors of complications. (3) Results: Patients in Group A had a significantly higher prevalence of diabetes mellitus (43.1% vs. 20.8%; <i>p</i> = 0.02) and cardiovascular disease (35.3% vs. 13.9%; <i>p</i> = 0.01). Elevated inflammatory markers (CRP ≥ 40 mg/L, IL-6 ≥ 30 pg/mL, procalcitonin ≥ 0.5 ng/mL) were strongly associated with higher complication rates. Microbiome analysis indicated dysbiosis in Group A, with reduced <i>Lactobacillus</i> and <i>Bifidobacterium</i> levels, increased <i>Enterobacteriaceae</i> abundance, and a lower Shannon Index (<2). Patients exhibiting both dysbiosis and elevated inflammation had the highest complication rate (60%). Multivariate analysis identified diabetes, elevated IL-6, and dysbiosis as independent predictors of adverse outcomes. (4) Conclusions: Postoperative complications after the modified Whipple procedure are influenced by systemic inflammation and gut dysbiosis. A systematic preoperative assessment of microbiome health and inflammatory markers enables accurate risk stratification and personalized interventions, potentially reducing the incidence of complications and improving overall surgical outcomes. |
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| id | doaj-art-0fcf907804564d2ba624504210460d50 |
| institution | Kabale University |
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| language | English |
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| spelling | doaj-art-0fcf907804564d2ba624504210460d502025-01-24T13:24:01ZengMDPI AGBiomedicines2227-90592025-01-0113110410.3390/biomedicines13010104Correlation Between Systemic Inflammation, Gut Microbiome Dysbiosis and Postoperative Complications After the Modified Whipple ProcedureGelu Mihai Breaza0Florin Emil Hut1Octavian Cretu2Simona-Alina Abu-Awwad3Ahmed Abu-Awwad4Laurențiu Vasile Sima5Radu Gheorghe Dan6Cristina Ana-Maria Dan7Raluca Maria Closca8Flavia Zara9Doctoral School, “Victor Babes” University of Medicine and Pharmacy, 300041 Timisoara, RomaniaUniversity Clinic of Surgery I, “Victor Babes” University of Medicine and Pharmacy, 300041 Timisoara, RomaniaUniversity Clinic of Surgery I, “Victor Babes” University of Medicine and Pharmacy, 300041 Timisoara, RomaniaIst Clinic of Obstetrics and Gynecology, “Pius Brinzeu” County Clinical Emergency Hospital, 300723 Timisoara, RomaniaDepartment XV—Discipline of Orthopedics—Traumatology, “Victor Babes” University of Medicine and Pharmacy, 300041 Timisoara, RomaniaUniversity Clinic of Surgery I, “Victor Babes” University of Medicine and Pharmacy, 300041 Timisoara, RomaniaUniversity Clinic of Surgery I, “Victor Babes” University of Medicine and Pharmacy, 300041 Timisoara, RomaniaUniversity Clinic of Surgery I, “Victor Babes” University of Medicine and Pharmacy, 300041 Timisoara, RomaniaDepartment of Pathology, Emergency City Hospital, 300254 Timisoara, RomaniaDepartment of Pathology, Emergency City Hospital, 300254 Timisoara, Romania(1) Background: The modified Whipple procedure, or pylorus-preserving pancreaticoduodenectomy, is a complex surgical intervention used to treat pancreatic head tumors. While preserving digestive function, it is associated with significant perioperative risks. This study explores the clinical, immunological, and microbiome-related factors influencing postoperative complications, focusing on the interplay between patient comorbidities, systemic inflammation, and gut dysbiosis. (2) Methods: A retrospective analysis was conducted on 123 patients undergoing the modified Whipple procedure for pancreatic head tumors. Patients were categorized into two groups based on the occurrence of significant postoperative complications (Group A: with complications; Group B: without complications). Data on demographics, comorbidities, inflammatory markers (CRP, IL-6, procalcitonin), and gut microbiome composition were collected. Microbial diversity was evaluated using the Shannon Index, and logistic regression was performed to identify independent predictors of complications. (3) Results: Patients in Group A had a significantly higher prevalence of diabetes mellitus (43.1% vs. 20.8%; <i>p</i> = 0.02) and cardiovascular disease (35.3% vs. 13.9%; <i>p</i> = 0.01). Elevated inflammatory markers (CRP ≥ 40 mg/L, IL-6 ≥ 30 pg/mL, procalcitonin ≥ 0.5 ng/mL) were strongly associated with higher complication rates. Microbiome analysis indicated dysbiosis in Group A, with reduced <i>Lactobacillus</i> and <i>Bifidobacterium</i> levels, increased <i>Enterobacteriaceae</i> abundance, and a lower Shannon Index (<2). Patients exhibiting both dysbiosis and elevated inflammation had the highest complication rate (60%). Multivariate analysis identified diabetes, elevated IL-6, and dysbiosis as independent predictors of adverse outcomes. (4) Conclusions: Postoperative complications after the modified Whipple procedure are influenced by systemic inflammation and gut dysbiosis. A systematic preoperative assessment of microbiome health and inflammatory markers enables accurate risk stratification and personalized interventions, potentially reducing the incidence of complications and improving overall surgical outcomes.https://www.mdpi.com/2227-9059/13/1/104pancreatic head cancermodified Whipple procedureperioperative complicationsimmunological markerspancreatic fistuladelayed gastric emptying |
| spellingShingle | Gelu Mihai Breaza Florin Emil Hut Octavian Cretu Simona-Alina Abu-Awwad Ahmed Abu-Awwad Laurențiu Vasile Sima Radu Gheorghe Dan Cristina Ana-Maria Dan Raluca Maria Closca Flavia Zara Correlation Between Systemic Inflammation, Gut Microbiome Dysbiosis and Postoperative Complications After the Modified Whipple Procedure Biomedicines pancreatic head cancer modified Whipple procedure perioperative complications immunological markers pancreatic fistula delayed gastric emptying |
| title | Correlation Between Systemic Inflammation, Gut Microbiome Dysbiosis and Postoperative Complications After the Modified Whipple Procedure |
| title_full | Correlation Between Systemic Inflammation, Gut Microbiome Dysbiosis and Postoperative Complications After the Modified Whipple Procedure |
| title_fullStr | Correlation Between Systemic Inflammation, Gut Microbiome Dysbiosis and Postoperative Complications After the Modified Whipple Procedure |
| title_full_unstemmed | Correlation Between Systemic Inflammation, Gut Microbiome Dysbiosis and Postoperative Complications After the Modified Whipple Procedure |
| title_short | Correlation Between Systemic Inflammation, Gut Microbiome Dysbiosis and Postoperative Complications After the Modified Whipple Procedure |
| title_sort | correlation between systemic inflammation gut microbiome dysbiosis and postoperative complications after the modified whipple procedure |
| topic | pancreatic head cancer modified Whipple procedure perioperative complications immunological markers pancreatic fistula delayed gastric emptying |
| url | https://www.mdpi.com/2227-9059/13/1/104 |
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