Abstract: Objective: To investigate the relationship between post-operative cognitive dysfunction (POCD) and regional cerebral oxygen saturation (rSO₂) and β-amyloid protein (Aβ) in patients undergoing laparoscopic pancreaticoduodenectomy. Methods: Fifty patients undergoing elective laparoscopic pancreaticoduodenectomy received five groups of neuropsychological tests 1 d pre-operatively and 7 d post-operatively, with continuous monitoring of rSO₂ intra-operatively. Before anesthesia induction (t₀), at the beginning of laparoscopy (t₁), and at the time of pneumoperitoneum 120 min (t₂), pneumoperitoneum 240 min (t₃), pneumoperitoneum 480 min (t₄), the end of pneumoperitoneum (t₅), and 24 h after surgery, jugular venous blood was drawn respectively for the measurement of Aβ by enzyme-linked immunosorbent assay (ELISA). Results: Twenty-one cases of the fifty patients suffered from POCD after operation. We found that the maximum percentage drop in rSO₂ (rSO_{2, %max}) was significantly higher in the POCD group than in the non-POCD group. The rSO_{2, %max} value of over 10.2% might be a potential predictor of neurocognitive injury for those patients. In the POCD group, the plasma Aβ levels after 24 h were significantly higher than those of pre-operative values (P<0.01). After 24 h, levels of plasma Aβ in the POCD group were significantly higher than those in the non-POCD group (P<0.01). Conclusions: The development of POCD in patients undergoing laparoscopic pancreaticoduodenectomy is associated with alterations of rSO₂ and Aβ. Monitoring of rSO₂ might be useful in the prediction of POCD, and Aβ might be used as a sensitive biochemical marker to predict the occurrence of POCD.

Key words: Laparoscopic pancreaticoduodenectomy, Regional cerebral oxygen saturation, β-Amyloid protein, Post-operative cognitive dysfunction

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