Match!

Postoperative pancreatic fistula: an international study group (ISGPF) definition.

Published on Jul 1, 2005in Surgery3.476
· DOI :10.1016/j.surg.2005.05.001
Claudio Bassi80
Estimated H-index: 80
(University of Verona),
Christos Dervenis45
Estimated H-index: 45
+ 7 AuthorsMarkus W. Büchler127
Estimated H-index: 127
(University Hospital Heidelberg)
Sources
Abstract
Background Postoperative pancreatic fistula (POPF) is still regarded as a major complication. The incidence of POPF varies greatly in different reports, depending on the definition applied at each surgical center. Our aim was to agree upon an objective and internationally accepted definition to allow comparison of different surgical experiences. Methods An international panel of pancreatic surgeons, working in well-known, high-volume centers, reviewed the literature on the topic and worked together to develop a simple, objective, reliable, and easy-to-apply definition of POPF, graded primarily on clinical impact. Results A POPF represents a failure of healing/sealing of a pancreatic-enteric anastomosis or a parenchymal leak not directly related to an anastomosis. An all-inclusive definition is a drain output of any measurable volume of fluid on or after postoperative day 3 with an amylase content greater than 3 times the serum amylase activity. Three different grades of POPF (grades A, B, C) are defined according to the clinical impact on the patient's hospital course. Conclusions The present definition and clinical grading of POPF should allow realistic comparisons of surgical experiences in the future when new techniques, new operations, or new pharmacologic agents that may impact surgical treatment of pancreatic disorders are addressed.
  • References (51)
  • Citations (2877)
📖 Papers frequently viewed together
446 Citations
1,504 Citations
20073.48Surgery
1,083 Citations
78% of Scinapse members use related papers. After signing in, all features are FREE.
References51
Newest
#1Claudio Bassi (University of Verona)H-Index: 80
#2Giovanni Butturini (University of Verona)H-Index: 36
Last. Paolo Pederzoli (University of Verona)H-Index: 68
view all 8 authors...
Background: Pancreatic fistula (PF) is still regarded as a serious complication both in terms of frequency and sequelae. The incidence varies greatly in different reports because of
223 CitationsSource
#1Bertrand SucH-Index: 23
#2Simon MsikaH-Index: 38
Last. Jacques ChipponiH-Index: 24
view all 9 authors...
Hypothesis Prophylactic administration of octreotide acetate decreases the rate of postoperative intra-abdominal complications (IACs) after elective pancreatic resection. Design Single-blind, controlled, randomized trial. Setting Multicenter (N = 20) trial in France. Patients Of 230 randomized patients undergoing pancreatoduodenectomy and pancreatic enteric anastomosis or distal pancreatectomy for either malignant or benign tumor or chronic pancreatitis, 122 were allotted intraoperatively to rec...
121 CitationsSource
#1Markus W. BüchlerH-Index: 127
#2Markus WagnerH-Index: 26
Last. Kaspar Z’graggenH-Index: 24
view all 6 authors...
Hypothesis Advances in specialized centers for pancreatic diseases have improved surgical morbidity and outcome. In the past, postoperative local complications (pancreatic fistulae) were causing most of the mortality. Now, more patients experience postoperative complications related to their comorbidity. Design To report a prospective audit of a single center's experience with pancreatic resection during an 8-year period. Setting Tertiary referral center focused on pancreatic diseases. Patients ...
429 CitationsSource
#1Yi-Ming Shyr (Taipei Veterans General Hospital)H-Index: 17
#2Cheng-Hsi Su (Taipei Veterans General Hospital)H-Index: 17
Last. Wing-YiuLui (Taipei Veterans General Hospital)H-Index: 43
view all 4 authors...
Le but de cette etude a ete de clarifier si le taux d'amylase dans le liquide de drainage peut predire une fistule pancreatique apres duodenopancreatectomie et de determiner les facteurs qui agissent sur le taux d'amylase dans ce liquide. On a mesure, dans le liquide de drainage des patients ayant eu une duodenopancreatectomie, le taux d'amylase entre les jours postoperatoires 1 a 7. La preuve directe d'une fistule pancreatique a ete obtenue au septieme jour postoperatoire par une fistulographie...
53 CitationsSource
Abstract Background Pancreatectomy can be complicated by pancreatic anastomotic leakage, causing major morbidity. Study design Our aim was to determine if vapreotide, a potent long-acting somatostatin analogue, would decrease pancreas-related complications. This prospective, multicenter, randomized, double-blind, placebo-controlled trial involved 275 patients without preexisting chronic pancreatitis undergoing elective proximal, central, or distal pancreatectomy. Complications were defined by ob...
141 CitationsSource
#1Masahiko YamaguchiH-Index: 14
#2HiroshiNakanoH-Index: 27
Last. Kaoru KumadaH-Index: 23
view all 6 authors...
Background/Aims: We investigated whether it would be useful to monitor amylase levels of drainage fluid after pancreatic surgery for prediction of pancreatic fistula. Methodology: Twenty-six cases in which amylase levels of drainage fluid were determined after pancreatic surgery, were divided into 14 cases who did not develop pancreatic fistula and 12 cases who developed pancreatic fistula. Changes in amylase levels of sera and urine as well as drainage fluid were monitored. Results: Amylase lev...
24 Citations
#1Bertrand SucH-Index: 23
#2Simon MsikaH-Index: 38
Last. Pierre-Louis FagniezH-Index: 39
view all 8 authors...
Morbidity and mortality after partial pancreatectomy are essentially secondary to intra-abdominal complications (pancreatic, biliary, or digestive tract fistula, acute pancreatitis) and their consequences (abscess, hemorrhage); rates range from 20%1 to 40%2 and from 0%1 to 15%, 3 respectively, and cannot be underestimated. The main cause of these complications is anastomotic or suture leakage or fistula arising from the pancreatic stump. 1,2 The rate of the latter ranges between 7.5%4 and 38%. 5...
213 CitationsSource
#1Charles J. Yeo (Johns Hopkins University)H-Index: 127
#2John L. Cameron (Johns Hopkins University)H-Index: 118
Last. Ralph H. Hruban (Johns Hopkins University)H-Index: 163
view all 9 authors...
Pancreaticoduodenectomy (the Whipple procedure) is the traditional resectional procedure for patients with periampullary adenocarcinoma (carcinoma of the head, neck, or uncinate process of the pancreas; ampulla of Vater; distal common bile duct; or peri-Vaterian duodenum). The outcomes of patients undergoing surgical resection depend on various tumor-specific factors 1–7 (e.g., primary tumor location, tumor size, status of resection margins and the presence or absence of lymph node metastases), ...
660 CitationsSource
#1Steven M. Strasberg (WashU: Washington University in St. Louis)H-Index: 57
#2Jeffrey A. Drebin (WashU: Washington University in St. Louis)H-Index: 33
Last. David C. Linehan (WashU: Washington University in St. Louis)H-Index: 50
view all 7 authors...
Abstract BACKGROUND: Anastomotic failure at the pancreaticojejunostomy after a Whipple procedure, manifested either as a pancreatic fistula or intraabdominal abscess, is still an unacceptably common postoperative complication. STUDY DESIGN: A prospectively collected series of 123 patients underwent a Whipple procedure. During the pancreaticojejunostomy, the blood supply at the cut surface of the pancreas was evaluated, and if deemed inadequate, the pancreas was cut back 1.5 to 2.0 cm to improve ...
145 CitationsSource
#1Robert C.G. MartinH-Index: 56
#2Murray F. BrennanH-Index: 142
Last. David P. JaquesH-Index: 38
view all 3 authors...
Although an array of short-term postoperative outcomes such as operative time, estimated blood loss, blood transfusion, length of hospital stay, time to return to work, or hospital charges have been reported, death and complication rates remain the most frequently measured and reported endpoints. With their preeminence as surgical outcome measures, they are often the sole data provided as a means of comparing surgical techniques or perioperative management decisions. Complication reports within ...
437 CitationsSource
Cited By2877
Newest
#1S. Lof (University of Southampton)H-Index: 1
#1Sanne LofH-Index: 2
Last. M. Abu HilalH-Index: 22
view all 19 authors...
Background: Several studies have suggested a survival benefit of neoadjuvant therapy (NAT) for pancreatic ductal adenocarcinoma (PDAC) in the pancreatic head. Data concerning NAT for PDAC located in pancreatic body or tail are lacking. Methods: Post hoc analysis of an international multicenter retrospective cohort of distal pancreatectomy for PDAC in 34 centers from 11 countries (2007–2015). Patients who underwent resection after NAT were matched (1:1 ratio), using propensity scores based on bas...
Source
#1Sivesh K. Kamarajah (Newcastle University)H-Index: 6
#2James Bundred (University of Birmingham)H-Index: 1
Last. Benjamin Loveday (University of Auckland)H-Index: 11
view all 6 authors...
Source
#1Mark J. Truty (Mayo Clinic)H-Index: 23
#2Jill J. Colglazier (Mayo Clinic)
Last. Michael L. Kendrick (Mayo Clinic)H-Index: 45
view all 10 authors...
Abstract Background En bloc celiac axis resection (CAR) for pancreatic cancer (PC) is increasingly considered after modern neoadjuvant chemotherapy (NAC). “Appleby” and “DP-CAR” are anatomically inaccurate terms as tumors can extend beyond celiac axis proper requiring concurrent resection of the proper hepatic artery and/or superior mesenteric artery. Study Design A 3-level classification for CAR (Class 1/2/3) was developed after retrospective review of arterial resection database describing ana...
Source
Source
#1You-Meng Sun (ZJU: Zhejiang University)
#2Ying Wang (ZJU: Zhejiang University)H-Index: 12
Last. Wei Wang (ZJU: Zhejiang University)H-Index: 16
view all 4 authors...
Source
#1Harjeet Singh (PGIMER: Post Graduate Institute of Medical Education and Research)H-Index: 5
Last. Thakur Deen Yadav (PGIMER: Post Graduate Institute of Medical Education and Research)H-Index: 13
view all 8 authors...
BACKGROUND: Infectious complications cause significant morbidity after pancreatoduodenectomy (PD). The impact of uncontrolled spillage of bile during PD has not been systematically studied. METHODS: Patients undergoing PD for malignant lesions between March 2017 and May 2019 were considered for inclusion. All patients underwent standard pre-operative preparation and antibiotic prophylaxis. After confirmation of resectability, the patients were randomized into one of the two groups: common hepati...
Source
BACKGROUND: We investigated perioperative outcomes of pancreaticoduodenectomy (PD) in patients receiving antithrombotic therapy (ATT) with a focus on the incidence of perioperative bleeding and thromboembolic complications. METHODS: A total of 77 patients who underwent PD at our institution between 2013 and 2019 were retrospectively reviewed. Clinical findings and surgical outcomes including bleeding and thromboembolic complications were compared in patients with or without ATT. Interruption of ...
Source
#1Vishes Mehta (Albert Einstein College of Medicine)
#2Patricia Friedmann (Albert Einstein College of Medicine)H-Index: 25
Last. Haejin In (Albert Einstein College of Medicine)H-Index: 5
view all 5 authors...
BACKGROUND: The impact of emergency department admission prior to pancreatic resection on perioperative outcomes is not well described. We compared patients who underwent pancreatic cancer surgery following admission through the emergency department (ED-surgery) with patients receiving elective pancreatic cancer surgery (elective) and outcomes. STUDY DESIGN: The Nationwide Inpatient Sample database was used to identify patients undergoing pancreatectomy for cancer over 5 years (2008-2012). Demog...
Source
#1Krishna ShanbhogueH-Index: 4
#2Ali Pourvaziri (U of T: University of Toronto)
Last. Avinash Kambadakone (Harvard University)H-Index: 21
view all 4 authors...
Chronic pancreatitis is a chronic fibro-inflammatory syndrome characterized by chronic pancreatic inflammation leading to fibrosis and scarring. Patients with this multifactorial debilitating illness often require endoscopic or surgical intervention for treatment. Radiologists play a crucial role in pre-therapeutic workup as well as post-treatment imaging of chronic pancreatitis. This review summarizes the most common surgical and endoscopic treatment options that are currently available for chr...
Source
BACKGROUND: Insulinomas are found in 10-15 per cent of patients with multiple endocrine neoplasia type 1 (MEN1) and lead to life-threatening hypoglycaemia. Surgical outcome and the optimal surgical strategy for MEN1-related insulinoma are unknown. METHODS: Patients with MEN1-related insulinomas were identified in 46 centres in Europe and North America between 1990 and 2016. Insulinomas were considered localized if the lesion was in the pancreatic head or body/tail. Patients with pancreatic neuro...
Source