Risk stratification for postoperative pancreatic fistula using the pancreatic surgery registry StuDoQ|Pancreas of the German Society for General and Visceral Surgery

Pancreatology ◽  
2019 ◽  
Vol 19 (1) ◽  
pp. 17-25 ◽  
Author(s):  
Ekaterina Petrova ◽  
Hryhoriy Lapshyn ◽  
Dirk Bausch ◽  
Jan D'Haese ◽  
Jens Werner ◽  
...  
2018 ◽  
Vol 68 (12) ◽  
pp. 2875-2878
Author(s):  
Delia Rusu Andriesi ◽  
Ana Maria Trofin ◽  
Irene Alexandra Cianga Spiridon ◽  
Corina Lupascu Ursulescu ◽  
Cristian Lupascu

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.


2019 ◽  
Vol 42 (1) ◽  
pp. 5-9
Author(s):  
A. A. Litvin ◽  
S. I. Sychev ◽  
A. A. Miroshnichenko ◽  
Y. A. Kolokoltseva

Modern standards of registering the medical information involve a creation of registers of patients with various nosologicalentities, which allows to standardize the services provided by the health care system, as well as to increase the efficiency and safety of treatment in actual clinical practice. The Pancreatic Disease Register of the German Society of General and Visceral Surgery, which is a database of patients with pancreatic diseases and their surgeries, has become very popular in the medical field. The register is a multidisciplinary database with its own infrastructure, coordination center and it contains information on surgical diseases and surgical interventions performed on the pancreas. The register is used to collect and analyze information online and integrates clinics of German-speaking countries (Germany, Switzerland, Austria), as well as doctors from other countries after receiving the relevant permission. The review analyzes the features of information collection and the creation of own register infrastructure, aspects of the implementation of methodological and organizational support, as well as the nuances of its logistics. The ways of statistical processing and validation of the collected information are listed, the possibility of autonomous functioning of the system and the presence of strict measures to protect the confidentiality of data are emphasized. The register is an optimal set of possibilities for correct, full-fledged introduction and analysis of extensive medical data, which is a prerequisite for conducting the prospective randomized studies in the field of pancreatic surgery.


HPB ◽  
2019 ◽  
Vol 21 ◽  
pp. S849
Author(s):  
O. Strobel ◽  
U. Hinz ◽  
T. Hank ◽  
W. Niesen ◽  
T. Hackert ◽  
...  

2017 ◽  
Vol 106 (3) ◽  
pp. 216-223 ◽  
Author(s):  
N. Dusch ◽  
A. Lietzmann ◽  
F. Barthels ◽  
M. Niedergethmann ◽  
F. Rückert ◽  
...  

Introduction: The perioperative morbidity following pancreas surgery remains high due to various specific complications: postoperative pancreatic fistula, postpancreatectomy hemorrhage, and delayed gastric emptying. The International Study Group of Pancreatic Surgery has defined these complications. The aim of this study is to evaluate the clinical applicability, to validate the International Study Group of Pancreatic Surgery definition, and to evaluate the postoperative morbidity. Methods: Between 2004 and 2014, 769 patients underwent resection. Data were collected in a prospective database. Univariate examination was performed using the χ2-test. Continuous data were tested with the Mann–Whitney U-test. Student’s t-tests and Fisher’s exact tests were performed. Results: A total of 542 patients were included in this study. In all, 91 (16.8%) patients developed postoperative pancreatic fistula, 69 of them clinically relevant grades B and C postoperative pancreatic fistula. Grades B and C postoperative pancreatic fistulas were significantly associated with a longer hospital stay. The postoperative pancreatic fistula grade significantly correlated with re-operation. Totally, 32 (5.9%) patients developed postpancreatectomy hemorrhage. Postpancreatectomy hemorrhage grade was significantly associated with re-operation and 30-day mortality. In all, 14 of 19 patients with grade C postpancreatectomy hemorrhage (73.7%) were re-operated; 3 had a simultaneous postoperative pancreatic fistula C. Grade B postpancreatectomy hemorrhage significantly prolonged hospital stay. Grade C postpancreatectomy hemorrhage significantly prolonged intensive care unit stay. Grade C postpancreatectomy hemorrhage led to longer intensive care unit stay but a shorter hospital stay. Delayed gastric emptying occurred in 131 (24.2%) patients. The delayed gastric emptying grade was significantly associated with re-operation. Nine of the re-operated patients had a simultaneous postoperative pancreatic fistula C. Grades A, B, and C delayed gastric emptying were associated with prolonged hospital- and intensive care unit stay. Conclusion: Delayed gastric emptying is the most common specific complication after pancreas resection, followed by postoperative pancreatic fistula and postpancreatectomy hemorrhage. The International Study Group of Pancreatic Surgery definitions are well applicable in clinical routine and the different grades correlate well with severity of clinical condition, length of hospital or intensive care unit stay, and mortality. Their widespread use can contribute to a more reproducible and reliable comparison of surgical outcomes in pancreas surgery.


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