The impact of individualized short-term prehabilitation on perioperative complications and inflammatory markers in pancreaticoduodenectomy: a single-center historical cohort study

Background: Prehabilitation has emerged as a promising strategy to enhance physiological reserve and improve surgical outcomes. This study aimed to evaluate the impact of a short-term prehabilitation program on perioperative complications and inflammatory responses in patients undergoing pancreaticoduodenectomy (PD). Methods: Consecutive patients scheduled for PD between October 2024 and October 2025 were assessed for eligibility for the prehabilitation program. The intervention group underwent a minimum two-week, individualized, multimodal prehabilitation program involving physical exercise, nutritional optimization, and psychological support. A historical control cohort was established for comparison, comprising patients who underwent PD without prehabilitation between July 2023 to September 2024. Postoperative outcomes, including postoperative pancreatic fistula (POPF), delayed gastric emptying (DGE), length of hospital stay, readmission rates, mortality, and inflammatory markers (white blood cell count, C-reactive protein [CRP], and neutrophil -to-lymphocyte ratio[NLR]), were systematically recorded. Results: > 0.05). Conclusion: Short-term prehabilitation attenuates the perioperative blood cell and CRP response and improves functional capacity and quality of life, but it does not significantly reduce postoperative complication rates in this cohort.