scholarly journals Critical Appraisal of 232 Consecutive Distal Pancreatectomies With Emphasis on Risk Factors, Outcome, and Management of the Postoperative Pancreatic Fistula

2008 ◽  
Vol 143 (10) ◽  
pp. 956 ◽  
Author(s):  
Brian K. P. Goh
Keyword(s):  
Risk Factors ◽  
Pancreatic Fistula ◽  
Critical Appraisal ◽  
Postoperative Pancreatic Fistula

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.

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

scholarly journals Kiguchi Method, A Novel Simplified Technique For Pancreaticojejunostomy In Minimally Invasive Pancreaticoduodenectomy, Significantly Reduces Postoperative Pancreatic Fistula Rate In Patients With A Soft Pancreatic Texture 

2020 ◽  
Author(s):  
Gozo Kiguchi ◽  
Atsushi Sugioka ◽  
Masaya Nakauchi ◽  
Masayuki Kojima ◽  
Akira Yasuda ◽  
...  
Keyword(s):  
Risk Factors ◽  
Minimally Invasive ◽  
Hospital Stay ◽  
Pancreatic Fistula ◽  
Postoperative Pancreatic Fistula ◽  
Pancreatic Texture ◽  
Technical Issues ◽  
Fistula Rate ◽  
Robotic Pancreaticoduodenectomy ◽  
Open Pancreaticoduodenectomy

Abstract Background: Minimally invasive pancreaticoduodenectomy (MIPD), including laparoscopic pancreaticoduodenectomy (LPD) and robotic pancreaticoduodenectomy (RPD), is especially demanding due to pancreaticojejunostomy (PJ). Postoperative pancreatic fistula (POPF) remains the most serious complication in MIPD as well as in open pancreaticoduodenectomy (OPD). Conventional PJ in MIPD did not improve the POPF rate and hospital stay, contrary to expectations. High POPF rates have been attributed to technical issues encountered during MIPD, including motion restriction and insufficient water tightness; therefore, we have developed the Kiguchi method as a novel PJ technique optimized for MIPD. Herein, we describe the technique and assess its impact in patients with a soft pancreatic texture, which has been reported to be significantly related to POPF.Methods: The retrospective study included 188 patients with a soft pancreatic texture. Briefly, 143 patients underwent OPD with conventional PJ (OPD group); 19 patients underwent MIPD with conventional PJ (Old-MIPD group), including 7 and 12 patients undergoing LPD and RPD, respectively; and 26 patients underwent MIPD using the Kiguchi method (New-MIPD group), including 15 and 11 patients undergoing LPD and RPD, respectively. Short-term outcomes were assessed, and POPF risk factors were determined using univariate and multivariate analyses.Results: The grade B/C POPF rate was significantly lower in the New-MIPD group than in the Old-MIPD and OPD groups (3.8% vs. 42.1% and 36.4%, respectively). The median hospital stay was significantly shorter in the New-MIPD group than in the Old-MIPD and OPD groups (23 vs. 33 and 31 days, respectively). By multivariate analysis, the PJ method and male sex were significant POPF risk factors. Among the patients without POPF, the hospital stay was significantly shorter in those undergoing MIPD than in those undergoing OPD, suggesting the advantage of MIPD. Conclusions: The novel Kiguchi method significantly reduced the POPF rate in patients with a soft pancreatic texture.

scholarly journals Postoperative pancreatic fistula affects recurrence-free survival of pancreatic cancer patients

PLoS ONE ◽  
2021 ◽  
Vol 16 (6) ◽  
pp. e0252727
Author(s):  
Sameer A. Dhayat ◽  
Ahmad N. J. Tamim ◽  
Marius Jacob ◽  
Georg Ebeling ◽  
Laura Kerschke ◽  
...  
Keyword(s):  
Risk Factors ◽  
Regression Analysis ◽  
Pancreatic Fistula ◽  
Tumor Recurrence ◽  
Postoperative Pancreatic Fistula ◽  
Recurrence Free Survival ◽  
Free Survival ◽  
Staining Score ◽  
Drain Fluid ◽  
Picrosirius Red

Purpose Postoperative pancreatic fistula (POPF) with reported incidence rates up to 45% contributes substantially to overall morbidity. In this study, we conducted a retrospective evaluation of POPF along with its potential perioperative clinical risk factors and its effect on tumor recurrence. Methods Clinical data on patients who had received pancreatoduodenectomy (PD), distal pancreatectomy (DP), or duodenum-preserving pancreatic head resection (DPPHR) were prospectively collected between 2007 and 2016. A Picrosirius red staining score was developed to enable morphological classification of the resection margin of the pancreatic stump. The primary end point was the development of major complications. The secondary end points were overall and recurrence-free survival. Results 340 patients underwent pancreatic resection including 222 (65.3%) PD, 87 (25.6%) DP, and 31 (9.1%) DPPHR. Postoperative major complications were observed in 74 patients (21.8%). In multivariable logistic regression analysis, POPF correlated with body mass index (BMI) (p = 0.025), prolonged stay in hospital (p<0.001), high Picrosirius red staining score (p = 0.049), and elevated postoperative levels of amylase or lipase in drain fluid (p≤0.001). Multivariable Cox regression analysis identified UICC stage (p<0.001), tumor differentiation (p<0.001), depth of invasion (p = 0.001), nodal invasion (p = 0.001), and the incidence of POPF grades B and C (p = 0.006) as independent prognostic markers of recurrence-free survival. Conclusion Besides the known clinicopathological risk factors BMI and amylase in the drain fluid, the incidence of POPF correlates with high Picrosirius red staining score in the resection margins of the pancreatic stumps of curatively resected pancreatic ductal adenocarcinoma (PDAC). Furthermore, clinically relevant POPF seems to be a prognostic factor for tumor recurrence in PDAC.

scholarly journals Pancreatic fistula risk assessment after distal pancreatectomy: a retrospective controlled study

2021 ◽  
Vol 28 (2) ◽  
pp. 33-45
Author(s):  
E. S. Drozdov ◽  
E. B. Topolnitskiy ◽  
S. S. Klokov ◽  
T. V. Dibina
Keyword(s):  
Risk Factors ◽  
Pancreatic Fistula ◽  
Pancreatic Duct ◽  
Distal Pancreatectomy ◽  
Main Pancreatic Duct ◽  
Postoperative Pancreatic Fistula ◽  
Controlled Study ◽  
Morphological Examination ◽  
Distal Pancreatic Resection ◽  
Duct Diameter

Background. Despite declining mortality, postoperative pancreatic fistula (PPF) remains a common complication of distal pancreatic resection surgery challenging to clinical prediction.Objectives. Prognostic analysis of the postoperative pancreatic fistula risk factors in patients with previous distal pancreatectomy.Methods. A retrospective controlled assay enrolled 107 patients, including 63 (58.9%) male and 44 (41.1%) female patients. All patients underwent distal pancreatectomy followed by a morphological examination of resected material. All patients had a general and biochemical blood panel profiling. Pancreatic tissue density at a putative resection zone was assessed with computed tomography. The patients were allocated to two cohorts: (1) not developing PPF (77 patients) and (2) having postoperative PPF complications (30 patients.Results. No statistically significant differences by age, gender, ASA and BMI scores were observed in study cohorts. Multivariate analysis revealed a statistically significant correlation of the PPF rate with the following factors: main pancreatic duct diameter <3 mm (odds ratio (OR) 1.02, 95% confidence interval (CI) 1.01–1.05, p = 0.01), pancreatic density at putative resection zone <30 HU in CT (OR 3.18, 95% CI 1.38–7.74, p < 0.01) and differential albumin of postoperative day 1 vs. pre-surgery >14 g/L (OR 3.13, 95% CI 1.19–8.24, p < 0.01).Conclusion. A main pancreatic duct diameter <3 mm, pancreatic density at putative resection zone <30 HU in CT and differential albumin of postoperative day 1 vs. pre-surgery >14 g/L are independent risk factors of postoperative fistulae.

Risk Factors for Life-threatening Grade C Postoperative Pancreatic Fistula After Pancreatoduodenectomy Compared to Grade B

2019 ◽  
Vol 39 (4) ◽  
pp. 2199-2205 ◽  
Author(s):  
NAOKAZU CHIBA ◽  
SHIGETO OCHIAI ◽  
KEI YOKOZUKA ◽  
TAKAHIRO GUNJI ◽  
TORU SANO ◽  
...  
Keyword(s):  
Risk Factors ◽  
Pancreatic Fistula ◽  
Postoperative Pancreatic Fistula ◽  
Life Threatening

scholarly journals Risk Factors of Postoperative Pancreatic Fistula after Pancreaticoduodenectomy: A Multicenter Cohort Study

HPB ◽  
2019 ◽  
Vol 21 ◽  
pp. S453
Author(s):  
Huisong Lee ◽  
Hyeon Kook Lee ◽  
Seog Ki Min ◽  
Korean Pancreas Surgery Club
Keyword(s):  
Risk Factors ◽  
Cohort Study ◽  
Pancreatic Fistula ◽  
Postoperative Pancreatic Fistula ◽  
Multicenter Cohort Study ◽  
Multicenter Cohort
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