Introduction : The aim of this study was to investigate whether preoperative malnutrition status in patients who underwent curative pancreaticoduodenectomy (PD) in pancreatic head cancer correlate with adverse outcomes, such as postoperative complications and short-term outcomes.

Methods : This study was a retrospective review using electronic medical records from January 2004 to December 2018. In this study, the preoperative malnutrition defined as body mass index (BMI) <18.5kg/m2, or hypoalbuminemia with serum albumin level <3.5g/dl within the 30 d before surgery.

Results : The proportion of patient underwent the neoadjuvant chemotherapy was higher in the normal patient group (10.5%) than malnutrition group (1.7%) (P=0.036). The rate of conversion from laparoscopic to open PD is significantly higher in malnutrition group (P=0.021). The mean operation time (min) was similar between groups (P=0.125) but the estimated blood loss (EBL, ml) (964.16±879.71 vs. 597.99±501.75, P=0.044) were significantly higher in the malnutrition group. Total hospital stays (days) (29.55±15.86 vs. 22.07±15.33, P=0.009) was significantly longer in malnutrition group. The overall incidence of major complications higher in malnutrition group. We conducted to sub-analysis whether EBL has a correlation with albumin level. The EBL was significantly higher in ‘<3.0g/dl’ group compared with patients with ‘3.0-3.5g/dl’, and ‘>3.5g/dl’ (1442.33±1279.62 vs 845.24±695.26 vs 600.60±506.61, P<0.001). Compared with patients with ‘3.0-3.5g/dl’, and ‘>3.5g/dl’ group, prothrombin time (PT) were significantly longer in ‘<3.0g/dl’ group (1.19±0.26 vs 1.05±0.11 vs 0.99±0.08, P<0.001).

Conclusions : Malnourished patients who underwent PD in pancreatic head cancer were more likely to have EBL, open conversion rate, hospital stay and postoperative major complications than those without preoperative malnutrition.