Back to Search Start Over

Risk factors for pancreatic fistula grade C after pancreatoduodenectomy: A large prospective, multicenter Japan-Taiwan collaboration study.

Authors :
Hirono S
Shimokawa T
Nagakawa Y
Shyr YM
Kawai M
Matsumoto I
Satoi S
Yoshitomi H
Okabayashi T
Motoi F
Amano R
Murakami Y
Hirano S
Kawamoto K
Nakamori S
Shan YS
Kobayashi S
Nitta H
Matsukawa H
Uchiyama K
Hsu CP
Kitami C
Yamamoto M
Hwang TL
Yamaue H
Source :
Journal of hepato-biliary-pancreatic sciences [J Hepatobiliary Pancreat Sci] 2020 Sep; Vol. 27 (9), pp. 622-631. Date of Electronic Publication: 2020 Aug 06.
Publication Year :
2020

Abstract

Background/purpose: Grade C postoperative pancreatic fistula (POPF), as defined by International Study Group of Pancreatic Fistula (ISGPF), is the most life-threatening complication after pancreatoduodenectomy (PD). This study aims to evaluate risk factors for Grade C POPF after PD.<br />Methods: This is a prospective, multicenter study based in Japan and Taiwan. Between December 2014 and May 2017, 3022 patients were enrolled in this study and 2762 patients were analyzed. We analyzed risk factors of Grade C POPF based on the updated 2016 ISGPF scheme (organ failure, reoperation, and/or death).<br />Results: Among 2762 patients, 46 patients (1.7%) developed Grade C POPF after PD. The mortality rate of the 46 patients with Grade C POPF was 37.0%. On the multivariate analysis, six independent risk factors for Grade C POPF were found; BMI ≥ 25.0 kg/m <superscript>2</superscript> , chronic steroid use, preoperative serum albumin <3.0 mg/dL, soft pancreas, operative time ≥480 minutes, and intraoperative transfusion. The c-statistic of our risk scoring model for Grade C POPF using these risk factors was 0.77. The score was significantly higher in Grade C POPF than in Grade B POPF (P < .001) or none/biochemical leak (P < .001).<br />Conclusions: This prospective study showed risk factors for Grade C POPF after PD.<br /> (© 2020 Japanese Society of Hepato-Biliary-Pancreatic Surgery.)

Details

Language :
English
ISSN :
1868-6982
Volume :
27
Issue :
9
Database :
MEDLINE
Journal :
Journal of hepato-biliary-pancreatic sciences
Publication Type :
Academic Journal
Accession number :
32621787
Full Text :
https://doi.org/10.1002/jhbp.799