Clinical Validation of the ISGPF Classification and the Risk Factors of Pancreatic Fistula Formation Following Duct-to-Mucosa Pancreaticojejunostomy by One Surgeon at a Single Center

2011 ◽  
Vol 15 (12) ◽  
pp. 2187-2192 ◽  
Author(s):  
Woo Seok Kim ◽  
Dong Wook Choi ◽  
Seong Ho Choi ◽  
Jin Seok Heo ◽  
Min Jung Kim ◽  
...  
Keyword(s):  
Risk Factors ◽  
Pancreatic Fistula ◽  
Fistula Formation ◽  
Clinical Validation ◽  
Single Center

Risk Factors for Pancreatic Fistula after Stapled Gland Transection

2011 ◽  
Vol 77 (8) ◽  
pp. 965-970 ◽  
Author(s):  
Preeti D. Subhedar ◽  
Sameer H. Patel ◽  
Peter J. Kneuertz ◽  
Shishir K. Maithel ◽  
Charles A. Staley ◽  
...  
Keyword(s):  
Risk Factors ◽  
Pancreatic Fistula ◽  
Staple Line ◽  
Univariate Analysis ◽  
Fistula Formation ◽  
Staple Line Reinforcement ◽  
Mesh Reinforcement ◽  
Included Patient ◽  
Pancreatic Transection ◽  
Clinically Significant

The objective of this study was to identify risk factors for pancreatic fistula (PF) after stapled transection in distal pancreatectomy (DP). Patients undergoing DP using a stapler for transection between 2005 and 2009 were identified from a pancreatic resection database. Variables examined included patient and tumor characteristics, staple size, and the use of mesh reinforcement. Univariate and multivariate regression analyses were performed to identify risk factors for postoperative PF. One hundred forty-nine had stapled transection, and of these, 25 (17%) had mesh reinforcement. The overall morbidity and mortality rates were 28 per cent and less than 1 per cent; 34 (23%) were diabetic. The rate of clinically significant PF was 14 per cent. On univariate analysis, diabetes ( P = 0.04), a firm pancreas ( P = 0.03), use of mesh staple line reinforcement ( P = 0.02), use of a 4.1-mm staple cartridge ( P = 0.01), and blood loss greater than 100 mL ( P = 0.01) were associated with higher pancreatic fistula rates. On multivariate analysis, only the presence of diabetes (OR, 4.17; 95% CI, 1.1-15.3; P = 0.03) and the use of a 4.1-mm cartridge (OR, 8.57; 95% CI, 1.2-60.2; P = 0.03) were independently associated with pancreatic fistula formation. Stapled pancreatic transection provides an acceptable PF rate after DP. Diabetes and staple size influence PF rates. In our experience, use of mesh staple line reinforcement did not reduce the incidence of PF after stapled transection.

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

Risk factors, predictors and prevention of pancreatic fistula formation after pancreatoduodenectomy

2007 ◽  
Vol 14 (6) ◽  
pp. 557-563 ◽  
Author(s):  
Takehiro Okabayashi ◽  
Michiya Kobayashi ◽  
Isao Nishimori ◽  
Takeki Sugimoto ◽  
Saburo Onishi ◽  
...  
Keyword(s):  
Risk Factors ◽  
Pancreatic Fistula ◽  
Fistula Formation

Short-term outcomes and risk factors for pancreatic fistula after pancreatic enucleation: A single-center experience of 142 patients

2017 ◽  
Vol 117 (2) ◽  
pp. 182-190 ◽  
Author(s):  
Xing Wang ◽  
Chun-lu Tan ◽  
Hao Zhang ◽  
Yong-Hua Chen ◽  
Min Yang ◽  
...  
Keyword(s):  
Risk Factors ◽  
Pancreatic Fistula ◽  
Single Center ◽  
Short Term ◽  
Single Center Experience

scholarly journals Retrospective analysis of risk factors for occurrence of pancreatic fistula in patients following pancreaticoduodenectomy

2018 ◽  
Vol 22 (3) ◽  
pp. 436-441
Author(s):  
K.G. Valikhnovska
Keyword(s):  
Risk Factors ◽  
Pancreatic Fistula ◽  
Pancreatic Duct ◽  
Retrospective Analysis ◽  
Pancreatic Head ◽  
Fistula Formation ◽  
Surgical Interventions ◽  
Periampullary Tumors ◽  
Pancreatic Fistulas

Pancreaticoduodenectomy still is a “gold standard” in treatment of hepatopancreaticobiliary tumors. The causes of pancreatic fistula were analyzed in 414 patients aged from 22 to 81 following pancreaticoduodenectomy due to periampullary tumors. The said patients were operated on during the period from 2008 to 2017. The aim of this study is to improve outcomes of pancreatic resection based on a retrospective analysis of the causes of postoperative pancreatic fistulae and the development of a range of measures to prevent the above complication. Influence of risk factors of pancreatic fistula formation was evaluated by Pirson’s method (χ2). The factors contributing to the occurrence of pancreatic fistulas included type of resection (Whipple pancreaticoduodenectomy, pylorus preserving pancreaticoduodenectomy; χ2=8.616,1, p=0.0033, p<0.01), kind of pathology (cancer of the pancreatic head; χ2=7.658,1, p=0.0057, p<0.01), type of pancreaticojejunostomy (invaginative pancreatic duct-jejunostomy; χ2=17.83,1, p=0.0001, p<0.001) and technique for drainage of the major pancreatic duct (pancreaticojejunostomy on external drainage; χ2=16.40,1, p=0.0001, p<0.001). The detailed study of risk factors for the occurrence of pancreatic fistula is essential for improving the prognosis, prophylaxis and treatment of this pathology. The quality of the surgical intervention and the course of the postoperative period in patients with periampullary tumors depend on the choice of resection type, techniques for surgical interventions on the pancreas.

scholarly journals Pancreatic stump closure techniques and pancreatic fistula formation after distal pancreatectomy: Meta-analysis and single-center experience

PLoS ONE ◽  
2018 ◽  
Vol 13 (6) ◽  
pp. e0197553 ◽  
Author(s):  
Elke Tieftrunk ◽  
Ihsan Ekin Demir ◽  
Stephan Schorn ◽  
Mine Sargut ◽  
Florian Scheufele ◽  
...  
Keyword(s):  
Pancreatic Fistula ◽  
Distal Pancreatectomy ◽  
Meta Analysis ◽  
Fistula Formation ◽  
Single Center ◽  
Pancreatic Stump ◽  
Single Center Experience ◽  
Stump Closure

Short-term outcomes and risk factors for pancreatic fistula after pancreatic enucleation: Single-center experience of 142 patients

Pancreatology ◽  
2017 ◽  
Vol 17 (3) ◽  
pp. S53-S54
Author(s):  
Xing Wang ◽  
Chunlu Tan ◽  
Hao Zhang ◽  
Yonghua Chen ◽  
Min Yang
Keyword(s):  
Risk Factors ◽  
Pancreatic Fistula ◽  
Single Center ◽  
Short Term ◽  
Single Center Experience

scholarly journals Risk Factors of Pancreatic Fistula in Distal Pancreatectomy Patients

2019 ◽  
Vol 2019 ◽  
pp. 1-6
Author(s):  
Amyna Jiwani ◽  
Tabish Chawla
Keyword(s):  
Risk Factors ◽  
Risk Factor ◽  
Pancreatic Fistula ◽  
Distal Pancreatectomy ◽  
Surgical Techniques ◽  
Multivisceral Resection ◽  
Postoperative Pancreatic Fistula ◽  
The Body ◽  
Fistula Formation ◽  
Factors Associated

Introduction. Benign and malignant lesions of the pancreas located at the body and tail of the pancreas are managed by the standard procedure of distal pancreatectomy (DP). The mortality associated with this procedure is reported as less than 5% in high-volume centers. The major proportion of morbidity is comprised of pancreatic fistula with a reported incidence of 5% to 60%. The most considered risk factors associated with pancreatic fistula formation are soft pancreatic texture, diameter of the pancreatic duct <3 mm, intraoperative blood loss >1000 ml and surgical techniques. Among all these factors, the modifiable factor is the surgical technique. Several surgical techniques have been developed and modified for closure of the pancreatic remnant in the recent past in order to minimize the risk of pancreatic fistula and other complications. The main objective of the study is to analyze the factors associated with formation of pancreatic fistula after distal pancreatectomy. Patients and Methods. We performed a single-center retrospective study at Aga Khan University Hospital from January 2004 till December 2015. The perioperative and postoperative data of 131 patients who underwent pancreatic resection were recorded by using ICD 9 coding. 45 patients underwent distal pancreatectomy, out of which 38 were included in the study based on inclusion criteria. Variables were grouped into demographics, indications, operative details, and postoperative course. Statistical analysis software (SPSS) was used for analysis. Quantitative variables were presented as mean with standard deviation or median with interquartile range depending on the distribution of data. Study endpoints for the risk factor analysis were surgical morbidity and development of pancreatic fistula. Univariate logistic regressions were performed associated with study endpoints. P value less than 0.05 was considered significant. Results. Postoperative pancreatic fistula was the most common perioperative morbidity. The significant associated risk factor for pancreatic fistula was multivisceral resection as compared to spleen-preserving distal pancreatectomy (P value 0.039). However, the technique of stump closure when opted for suture techniques was seen to be associated with a higher occurrence of postoperative pancreatic fistula. The mortality rate was 2.6%. Conclusion. Postoperative pancreatic fistula is the most common complication seen after distal pancreatectomy in our series. Multivisceral resection is associated with a high incidence of pancreatic fistula and is a statistical significant predictor of pancreatic fistula.

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