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A grading system can predict clinical and economic outcomes of pancreatic fistula after pancreaticoduodenectomy: results in 755 consecutive patients

Published on Jan 1, 2011in Langenbeck's Archives of Surgery2.093
· DOI :10.1007/s00423-010-0719-x
Despoina Daskalaki3
Estimated H-index: 3
(University of Verona),
Giovanni Butturini36
Estimated H-index: 36
(University of Verona)
+ 3 AuthorsClaudio Bassi80
Estimated H-index: 80
(University of Verona)
Abstract
Aim Postoperative pancreatic fistula (POPF) has a wide range of clinical and economical implications due to the difference of the associated complications and management. The aim of this study is to verify the applicability of the International Study Group of Pancreatic Fistula (ISGPF) definition and its capability to predict hospital costs.
  • References (26)
  • Citations (43)
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References26
Newest
#1Sébastien GaujouxH-Index: 31
#2Alexandre CortesH-Index: 6
Last. Jacques BelghitiH-Index: 105
view all 10 authors...
Background Pancreatic fistula (PF) after pancreatoduodenectomy (PD) remains a challenging problem. The only commonly accepted risk factor is the soft consistency of the pancreatic remnant. Methods In all, 100 consecutive patients underwent PD. All data, including commonly accepted risk factors for PF and PF defined according to the International Study Group of Pancreatic Fistula, were collected prospectively. On the pancreatic margin, a score of fibrosis and a score of fatty infiltration were as...
155 CitationsSource
#1Susan Tsai (Johns Hopkins University)H-Index: 23
#2Michael A. Choti (Johns Hopkins University)H-Index: 85
Last. Timothy M. Pawlik (Johns Hopkins University)H-Index: 82
view all 11 authors...
Background To examine the effect of body mass index (BMI) on clinicopathologic factors and long-term survival in patients undergoing pancreaticoduodenectomy for pancreatic adenocarcinoma.
65 CitationsSource
OBJECTIVE. The purpose of this study was to evaluate the sensitivity and specificity of routine performance of CT on postoperative day 7 in patients at high risk of pancreatic fistula after pancreaticoduodenectomy.MATERIALS AND METHODS. Two radiologists analyzed images from CT examinations of 50 patients with soft pancreas 7 days after pancreaticoduodenectomy. Pancreatic fistula was defined at CT as a fluid collection close to the pancreaticogastric or pancreaticojejunal anastomosis. Clinicobiol...
21 CitationsSource
#1Mark P. Callery (Harvard University)H-Index: 48
#2Wande B. Pratt (Harvard University)H-Index: 17
Last. Charles M. Vollmer (Harvard University)H-Index: 40
view all 3 authors...
Despite significant improvements in the safety and efficacy of pancreatic surgery, post-operative pancreatic fistulae remain an unsolved dilemma. These occur when the transected pancreatic gland, pancreatic-enteric anastomosis, or both, leak rendering the patient at significant risk. They are especially important today since indications for resection (IPMN, carcinoma) continue to increase. This review considers definitions and classifications of pancreatic fistulae, risk factors, preventative ap...
78 CitationsSource
#1Wande B. Pratt (BIDMC: Beth Israel Deaconess Medical Center)H-Index: 17
#2Mark P. Callery (BIDMC: Beth Israel Deaconess Medical Center)H-Index: 48
Last. Charles M. Vollmer (BIDMC: Beth Israel Deaconess Medical Center)H-Index: 40
view all 3 authors...
Background: The International Study Group on Pancreatic Fistula (ISGPF) classification scheme has become a useful system for characterizing the clinical impact of pancreatic fistula. We sought to identify predictive factors that predispose patients to fistula, specifically those with clinical relevance (grades B/C), and to describe the clinical and economic significance of risk stratification within this framework.
213 CitationsSource
#1Tingbo Liang (ZJU: Zhejiang University)H-Index: 26
#2Xueli Bai (ZJU: Zhejiang University)H-Index: 20
Last. Shusen Zheng (ZJU: Zhejiang University)H-Index: 42
view all 3 authors...
Aims: The aim of the study is to validate a new classification of pancreatic fistula (PF) and to document risk factors for PF. Methods: A retrospective study was
41 CitationsSource
#1Enrico Molinari (University of Verona)H-Index: 37
#2Claudio Bassi (University of Verona)H-Index: 80
Last. Paolo Pederzoli (University of Verona)H-Index: 68
view all 8 authors...
Pancreaticoduodenectomy (PD) and distal pancreatic resection (DP) are now standardized interventions for benign and malignant pancreatic lesions. Because of recent improvements in surgical techniques and perioperative management, the incidence of mortality and morbidity have decreased, even if the latter is still around 20% to 50% in high volume centers.1–22 The most frequent postoperative complication is pancreatic fistula (PF), which is often associated with abdominal collections, abscesses, s...
182 CitationsSource
#1Steven M. Strasberg (WashU: Washington University in St. Louis)H-Index: 32
#2David C. Linehan (WashU: Washington University in St. Louis)H-Index: 50
Last. Jeffrey Barkun (McGill University)H-Index: 34
view all 4 authors...
60 CitationsSource
Background Pancreatic fistula (PF) and delayed gastric emptying (DGE) are, respectively, the most frightening and most frequent complications after pancreaticoduodenectomy (PD). This study was undertaken to determine which independent factors influence the development of PF and DGE after PD. Study Design Between January 1996 and December 2005, 131 consecutive patients underwent a PD with pancreaticogastrostomy. A total of 22 items, entered prospectively, were examined with univariate and multiva...
112 CitationsSource
#1Manabu Hashimoto (Akita University)H-Index: 14
#2Makoto KogaH-Index: 3
Last. Yuzo YamamotoH-Index: 26
view all 7 authors...
OBJECTIVE. Our objective was to establish the CT features that are indicative of pancreatic fistula after pancreaticoduodenectomy.CONCLUSION. A fluid collection seen on CT around the pancreaticojejunostomy site and in the pancreatic bed may be caused by pancreatic fistula in patients who have undergone pancreaticoduodenectomy. CT depiction of air bubbles in the fluid at these sites may strongly suggest the diagnosis of pancreatic fistula.
21 CitationsSource
Cited By43
Newest
#1Jelle C van Dongen (EUR: Erasmus University Rotterdam)
#2F. Jasmijn SmitsH-Index: 4
Last. Casper H.J. van Eijck (EUR: Erasmus University Rotterdam)H-Index: 51
view all 9 authors...
Abstract Background Early detection of major complications after pancreatoduodenectomy could improve patient management and decrease the “failure-to-rescue” rate. In this retrospective cohort study, we aimed to compare the value of C-reactive protein (CRP) and white blood cell count (WBC) in the early detection of complications after pancreatoduodenectomy. Methods We assessed pancreatoduodenectomies between January 2012 and December 2017. Major complications were defined as grade III or higher a...
Source
#1Yien Xiang (JLU: Jilin University)H-Index: 1
#2Jiacheng Wu (JLU: Jilin University)
Last. Xuewen Zhang (JLU: Jilin University)H-Index: 10
view all 8 authors...
ABSTRACTIntroduction: Postoperative pancreatic fistula is the most troublesome complication after pancreaticoduodenectomy, and is an on-going area of concern for pancreatic surgeons. The specific p...
Source
#1Giovanni Marchegiani (University of Verona)H-Index: 19
#2Stefano Andrianello (University of Verona)H-Index: 7
Last. Claudio Bassi (University of Verona)H-Index: 80
view all 4 authors...
3 CitationsSource
#1Ayman El Nakeeb (Mansoura University)H-Index: 18
#2Mohamed El Sorogy (Mansoura University)H-Index: 5
Last. Ahmed M. Elsabbagh (Mansoura University)H-Index: 2
view all 8 authors...
Abstract Background Few studies investigated biliary leakage after pancreaticoduodenectomy (PD) especially when compared to postoperative pancreatic fistula (POPF). This study was to determine the incidence of biliary leakage after PD, predisposing factors of biliary leakage, and its management. Methods We retrospectively studied all patients who underwent PD from January 2008 to December 2017 at Gastrointestinal Surgery Center, Mansoura University, Egypt. According to occurrence of postoperativ...
Source
#1Fang Yuan (UVA: University of Virginia)
#2Amiram Gafni (McMaster University)H-Index: 74
Last. Pablo E. Serrano (McMaster University)H-Index: 5
view all 4 authors...
Background Previous cost evaluation studies reported either no increase or cost-saving using pasireotide in patients undergoing pancreaticoduodenectomy. We examined the likelihood and magnitude of cost-saving when using pasireotide at our institution to determine the generalizability of prior reports.
Source
#1M. El Amrani (university of lille)
#2M. Fulbert (university of lille)
Last. Stéphanie Truant (university of lille)H-Index: 20
view all 7 authors...
Summary Objective To define the cost of pancreatectomies and to identify factors associated with increased hospital costs after pancreatic resection. Methods All patients undergoing pancreatic surgery in our department between January 2008 and December 2014 were included. All complications occurring during hospitalization or in the 90-day period after discharge were documented. The hospital costs were analyzed and predictive factors of increased hospital costs were determined. Results One hundre...
Source
#1M. El Amrani (Lille University of Science and Technology)
#2Maxence Fulbert (Lille University of Science and Technology)H-Index: 1
Last. S. Truant (Lille University of Science and Technology)
view all 7 authors...
Resume But de l’etude Determiner le cout des pancreatectomies et identifier les facteurs associes a une majoration des couts hospitaliers apres resection pancreatique. Patients et methodes Les patients operes de resection pancreatique entre janvier 2008 et decembre 2014 ont ete inclus. Les donnees de morbimortalite durant l’hospitalisation ont ete recueillies ainsi que les couts globaux relatifs a toutes les depenses medicales durant l’hospitalisation initiale et les rehospitalisations dans les ...
Source
#1Jason W. Denbo (UMN: University of Minnesota)H-Index: 10
#2M. Bruno (University of Texas MD Anderson Cancer Center)H-Index: 4
Last. Matthew Harold Katz (University of Texas MD Anderson Cancer Center)H-Index: 41
view all 10 authors...
Abstract Background Postoperative pancreatic fistula is associated with adverse events, increased duration of stay and hospital costs. We developed perioperative care pathways stratified by postoperative pancreatic fistula risk with the aims of minimizing variations in care, improving quality, and decreasing costs. Study Design Three unique risk-stratified pancreatectomy clinical pathways—low-risk pancreatoduodenectomy, high-risk pancreatoduodenectomy, and distal pancreatectomy were developed an...
2 CitationsSource
#1Kevin M. Lewis (Baxter International)H-Index: 9
#2S Ikeme (Baxter International)H-Index: 2
Last. Carl Erik Kuntze (Baxter International)H-Index: 2
view all 4 authors...
ABSTRACTIntroduction: Intraoperative surgical sealants and hemostatic agents have been shown to reduce postoperative complications, transfusions, and hospital resource utilization. Despite availabi...
2 CitationsSource
#1Louise Barbier (AMU: Aix-Marseille University)H-Index: 11
#2Diane Mege (AMU: Aix-Marseille University)H-Index: 10
Last. Jean Robert Delpero (AMU: Aix-Marseille University)H-Index: 28
view all 6 authors...
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