Histomorphological Features of the Pancreatic Remnant as Independent Risk Factors for Postoperative Pancreatic Fistula: A Matched-Pairs Analysis

Pancreatology ◽  
2011 ◽  
Vol 11 (5) ◽  
pp. 516-524 ◽  
Author(s):  
Orlin Belyaev ◽  
Johanna Munding ◽  
Torsten Herzog ◽  
Dominique Suelberg ◽  
Andrea Tannapfel ◽  
...  
Keyword(s):  
Risk Factors ◽  
Pancreatic Fistula ◽  
Postoperative Pancreatic Fistula ◽  
Matched Pairs ◽  
Pancreatic Remnant ◽  
Independent Risk Factors

scholarly journals Preoperative CT anthropometric measurements and pancreatic pathology increase risk for postoperative pancreatic fistula in patients following pancreaticoduodenectomy

PLoS ONE ◽  
2020 ◽  
Vol 15 (12) ◽  
pp. e0243515
Author(s):  
Yun Hwa Roh ◽  
Bo Kyeong Kang ◽  
Soon-Young Song ◽  
Chul-Min Lee ◽  
Yun Kyung Jung ◽  
...  
Keyword(s):  
Risk Factors ◽  
Pancreatic Fistula ◽  
International Study ◽  
Multivariate Regression Analysis ◽  
Postoperative Pancreatic Fistula ◽  
Increase Risk ◽  
Preoperative Ct ◽  
Independent Risk Factors ◽  
Definition Of ◽  
Pancreatic Pathology

Postoperative pancreatic fistula (POPF) is a common complication following pancreaticoduodenectomy (PD). However, risk factors for this complication remain controversial. We conducted a retrospective analysis of 107 patients who underwent PD. POPF was diagnosed in strict accordance with the definition of the 2016 update of pancreatic fistula from the International Study Group on Pancreatic Fistula (ISGPF). Univariate and multivariate logistic regression analyses were performed to identify independent risk factors for POPF. A total of 19 (17.8%) subjects of pancreatic fistula occurred after PD, including 15 (14.1%) with grade B POPF and 4 (3.7%) with grade C POPF. There were 33 (30.8%) patients with biochemical leak. Risk factors for POPF (grade B and C) were larger area of visceral fat (odds ratio [OR], 1.40; p = 0.040) and pathology other than pancreatic adenocarcinoma or pancreatitis (OR, 12.45; p = 0.017) in the multivariate regression analysis. This result could assist the surgeon to identify patients at a high risk of developing POPF.

scholarly journals Comprehensive Diagnostic Nomogram for Predicting Clinically Relevant Postoperative Pancreatic Fistula After Pancreatoduodenectomy

2021 ◽  
Vol 11 ◽  
Author(s):  
Bo Li ◽  
Ning Pu ◽  
Qiangda Chen ◽  
Yong Mei ◽  
Dansong Wang ◽  
...  
Keyword(s):  
Risk Factors ◽  
Pancreatic Fistula ◽  
Predictive Value ◽  
Predictive Accuracy ◽  
Postoperative Pancreatic Fistula ◽  
Diagnostic Model ◽  
Discriminative Ability ◽  
Reactive Protein ◽  
Independent Risk Factors ◽  
Drain Amylase

BackgroundClinically relevant postoperative pancreatic fistula (CR-POPF) remains a severe and challenging complication of pancreaticoduodenectomy (PD). This study aimed to establish a novel postoperative nomogram-based diagnostic model for the early detection of CR-POPF in patients subjected to PD.MethodsConsecutive patients who underwent PD in Zhongshan Hospital, Fudan University from December 2018 to October 2020 were retrospectively enrolled. Univariate and multivariate logistic regression analyses were performed to identify independent risk factors for CR-POPF. Then, a novel predictive nomogram was established accordingly.ResultsAmong the consecutive 176 patients who underwent PD, 37 (21.1%) patients developed CR-POPF. Through univariate and multivariate analyses, the drain amylase (P = 0.002), serum creatinine (P = 0.009), and serum C reactive protein (P = 0.045) at postoperative day 1 (POD1) as well as the neutrophil count (P = 0.025) and temperature (P = 0.025) at POD3 were identified as independent risk factors for CR-POPF. Based on this, a novel predictive nomogram containing these factors was constructed to predict the probability of CR-POPF after PD. The formulated nomogram showed better performance to detect CR-POPF after PD with a sensitivity of 0.784, specificity of 0.770, positive predictive value of 0.475, and negative predictive value of 0.930 when compared to other predictors. In addition, the predictive value of the nomogram was assessed by a concordance index of 0.814 (95% CI, 0.736–0.892), which was significantly higher than indicators alone. This was further validated and depicted by decision curve analysis and clinical impact curve.ConclusionThis study established a diagnostic nomogram of postoperative objective parameters that can predict the development of CR-POPF after PD with a good discriminative ability and predictive accuracy.

scholarly journals Assessment of preoperative clinicophysiological findings as risk factors for postoperative pancreatic fistula after pancreaticoduodenectomy

2021 ◽  
Author(s):  
Shuji Suzuki ◽  
Mitsugi Shimoda ◽  
Jiro Shimazaki ◽  
Yukio Oshiro ◽  
Kiyotaka Nishida ◽  
...  
Keyword(s):  
Risk Factors ◽  
Pancreatic Fistula ◽  
Univariate Analysis ◽  
Prognostic Nutritional Index ◽  
Postoperative Pancreatic Fistula ◽  
Reactive Protein ◽  
Independent Risk Factors ◽  
Hospital Morbidity ◽  
Group B ◽  
Medical University

Objective Postoperative pancreatic fistula (POPF) is one of the severe complications that develop after pancreaticoduodenectomy (PD). This study aimed to assess the utility of preoperative clinicophysiological findings as risk factors for POPF after PD. Summary of Background Data We enrolled 350 patients who underwent PD between 2007 and 2012 at Tokyo Women’s Medical University. Methods In total, 350 patients who underwent PD between 2007 and 2012 were examined retrospectively. All patients were classified into two groups as follows: group A (no fistula/ biochemical leak group, 289 patients) and group B (grade B/C of POPF group 61 patients). Variables, including operative characteristics, length of stay in hospital, morbidity, mortality, and data regarding preoperative clinicophysiological parameters were collected and analyzed as predictors of POPF for univariate and multivariate analyses. Results There were 213 male and 137 female patients. The mean age was 65.4 years (range: 21-87years). Univariate analysis showed that sex (p=0.047), amylase (p=0.032), prognostic nutritional index (PNI) (p=0.001), C-reactive protein/Albumin ratio (p=0.005) were independent risk factors for POPF. In contrast, multivariate analysis showed that sex (p=0.045) and PNI (p=0.012) were independent risk factors for POPF. Conclusions Our results show that PNI (≤48.64 U/mL) and male sex were risk factors for POPF after PD, and especially, PNI can be suggested as an effective biomarker for POPF.

Clinical Impact of Preoperative Cholangitis after Biliary Drainage in Patients who Undergo Pancreaticoduodenectomy on Postoperative Pancreatic Fistula

2014 ◽  
Vol 80 (1) ◽  
pp. 36-42 ◽  
Author(s):  
Hiroaki Yanagimoto ◽  
Sohei Satoi ◽  
Tomohisa Yamamoto ◽  
Hideyoshi Toyokawa ◽  
Satoshi Hirooka ◽  
...  
Keyword(s):  
Risk Factors ◽  
Pancreatic Fistula ◽  
Biliary Drainage ◽  
Multivariate Analyses ◽  
Preoperative Biliary Drainage ◽  
Postoperative Pancreatic Fistula ◽  
Prophylactic Antibiotics ◽  
Clinical Background ◽  
Study Population ◽  
Independent Risk Factors

The objective of this study was to examine whether the development of cholangitis after preoperative biliary drainage (PBD) can increase the incidence of postoperative pancreatic fistula (POPF). The study population included 185 consecutive patients who underwent pancreaticoduodenectomy from April 2006 to March 2011. All patients were divided into two groups, which consisted of a “no PBD” group (73 patients) and a PBD group (112 patients). Moreover, the PBD group was divided into a “cholangitis” group (21 patients) and a “no cholangitis” group (91 patients). Clinical background, clinical outcome, and postoperative complications were compared between groups. All patients received prophylactic antibiotics using cefmetazole until 1 or 2 days postoperatively. There was no difference between noncholangitis and non-PBD groups except the frequency of overall POPF. Clinically relevant POPF and drain infection occurred in the cholangitis group significantly more than in the noncholangitis group ( P < 0.05). Univariate and multivariate analyses showed that development of preoperative cholangitis after preoperative biliary drainage and small pancreatic duct (less than 3 mm diameter) were independent risk factors for clinically relevant POPF. The frequency of clinically relevant POPF was 8 per cent (eight of 99) in patients without two risk factors, 19 per cent (15 of 80) in patients with one risk factor, and 50 per cent (three of six) in patients with both risk factors. The development of preoperative cholangitis after PBD was closely associated with the development of clinically relevant POPF under the limited use of prophylactic antibiotics.

Non-operative Risk Factors and the Implications of Sandostatin for Postoperative Pancreatic Fistula in Malignant Pancreatic Surgery

2018 ◽  
Vol 68 (12) ◽  
pp. 2875-2878
Author(s):  
Delia Rusu Andriesi ◽  
Ana Maria Trofin ◽  
Irene Alexandra Cianga Spiridon ◽  
Corina Lupascu Ursulescu ◽  
Cristian Lupascu
Keyword(s):  
Risk Factors ◽  
Pancreatic Fistula ◽  
Pancreatic Surgery ◽  
Postoperative Pancreatic Fistula ◽  
University Center ◽  
Preoperative Hemoglobin ◽  
Term Administration ◽  
Postoperative Administration

Pancreatic fistula is the most frecquent and severe postoperative complication after pancreatic surgery, with impressive implications for the quality of life and vital prognosis of the patient and for these reasons it is essential to identify risk factors. In the current study, who included 109 patient admitted to a single university center and who underwent pancreatic resection for malignant pathology, we assessed the following factors as risk factors: age, sex, preoperative hemoglobin value, preoperative total protein value, obesity and postoperative administration of sandostatin. Of the analyzed factors, it appears that only obesity and long-term administration of sandostatin influences the occurrence of pancreatic fistula.

Predicting the Severity of Pancreatic Fistula after Pancreaticoduodenectomy: Overweight and Blood Loss as Independent Risk Factors: Retrospective Analysis of 277 Patients

2019 ◽  
Vol 20 (6) ◽  
pp. 486-491 ◽  
Author(s):  
Alban Zarzavadjian Le Bian ◽  
David Fuks ◽  
Filippo Montali ◽  
Manuela Cesaretti ◽  
Renato Costi ◽  
...  
Keyword(s):  
Risk Factors ◽  
Blood Loss ◽  
Pancreatic Fistula ◽  
Retrospective Analysis ◽  
Independent Risk Factors

Risk Factors and Management of Postoperative Pancreatic Fistula Following Pancreaticoduodenectomy: Single-center Experience

2019 ◽  
Vol 39 (6) ◽  
pp. 1009-1018 ◽  
Author(s):  
Zun-xiang Ke ◽  
Jiong-xin Xiong ◽  
Jin Hu ◽  
Heng-yu Chen ◽  
Qin Li ◽  
...  
Keyword(s):  
Risk Factors ◽  
Pancreatic Fistula ◽  
Postoperative Pancreatic Fistula ◽  
Single Center ◽  
Single Center Experience
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