Predictive Factors for Postoperative Pancreatic Fistula

Abstract Background A serious complication after pancreatoduodenectomy (PD) is postoperative pancreatic fistula (POPF). The aim of this study was to analyse the incidence and predictive factors for POPF by using a large nationwide cohort. Methods Data from the Swedish National Registry for Pancreatic and Periampullary Cancer for all patients undergoing a PD from 2010 until 30th June 2018 were collected. The material was analysed in two groups, no POPF and clinically relevant (grade B and C) POPF. Results A total of 2503 patients underwent PD, of which 245 (10%) developed POPF. Patients with POPF had significantly more overall complications (Clavien Dindo ≥3a, 75% vs. 21%, p < 0.001) and longer hospital stay (median 23 [16–35] vs. 11 [8–15], p < 0.001) than patients without POPF. The risk of POPF was higher with increased BMI (OR 1.08, p < 0.001). Preoperative presence of diabetes (OR 0.52, p = 0.012) and preoperative biliary drainage (OR 0.34, p < 0.001) reduced the risk of POPF. Reconstruction with pancreaticojejunostomy caused a more than two folded increase in POPF compared with pancreaticogastrostomy (OR 2.41, p < 0.001). Weight gain ≥2 kg on postoperative day 1 was also a risk factor (OR 1.76, p < 0.001). Conclusion A high BMI, a pancreaticojejunostomy and postoperative weight gain were risk factors for developing POPF. Diabetes or preoperative biliary drainage was protective.

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Predictive factors associated with postoperative pancreatic fistula after laparoscopic distal pancreatectomy: a 10-year single-institution experience

Surgical Endoscopy ◽

10.1007/s00464-015-4255-1 ◽

2015 ◽

Vol 30 (2) ◽

pp. 649-656 ◽

Cited By ~ 20

Author(s):

Arturo S. Mendoza ◽

Ho-Seong Han ◽

Soyeon Ahn ◽

Yoo-Seok Yoon ◽

Jai Young Cho ◽

...

Keyword(s):

Pancreatic Fistula ◽

Distal Pancreatectomy ◽

Predictive Factors ◽

Laparoscopic Distal Pancreatectomy ◽

Postoperative Pancreatic Fistula ◽

Single Institution ◽

Factors Associated

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Predictive factors of postoperative pancreatic fistula after laparoscopic pancreatoduodenectomy

Annals of Translational Medicine ◽

10.21037/atm-20-1411 ◽

2021 ◽

Vol 9 (1) ◽

pp. 41-41

Author(s):

Jikuan Jin ◽

Guangbing Xiong ◽

Jiali Li ◽

Xingjun Guo ◽

Min Wang ◽

...

Keyword(s):

Pancreatic Fistula ◽

Predictive Factors ◽

Postoperative Pancreatic Fistula ◽

Laparoscopic Pancreatoduodenectomy

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The Severity of Postoperative Pancreatic Fistula Predicts 30-Day Unplanned Hospital Visit and Readmission after Pancreaticoduodenectomy: A Single-Center Retrospective Cohort Study

Healthcare ◽

10.3390/healthcare10010126 ◽

2022 ◽

Vol 10 (1) ◽

pp. 126

Author(s):

Hao-Wei Kou ◽

Chih-Po Hsu ◽

Yi-Fu Chen ◽

Jen-Fu Huang ◽

Shih-Chun Chang ◽

...

Keyword(s):

Pancreatic Fistula ◽

Predictive Factors ◽

Biliary Drainage ◽

Financial Burden ◽

Failure To Thrive ◽

Postoperative Recovery ◽

Postoperative Pancreatic Fistula ◽

Increased Risk ◽

Study Characteristics ◽

Unplanned Visit

Background: Unplanned hospital visits (UHV) and readmissions after pancreaticoduodenectomy (PD) impact patients’ postoperative recovery and are associated with increased financial burden and morbidity. The aim of this study is to identify predictive factors related to these events and target the potentially preventable UHV and readmissions. Methods: We enrolled 518 patients in this study. Characteristics were compared between patients with or without UHV and readmissions. Results: The unplanned visit and readmission rate was 23.4% and 15.8%, respectively. Postoperative pancreatic fistula (POPF) grade B or C, the presence of postoperative biliary drainage, and reoperation were found to be predictive factors for UHV, whereas POPF grade B or C and the presence of postoperative biliary drainage were independently associated with hospital readmission. The most common reason for readmission was an infection, followed by failure to thrive. The overall mortality rate in the readmission group was 4.9%. Conclusions: UHV and readmissions remain common among patients undergoing PD. Patients with grade B or C POPF assessed during index hospitalization harbor an approximately two-fold increased risk of subsequent unplanned visits or readmissions compared to those with no POPF or biochemical leak. Proper preventive strategies should be adopted for high-risk patients in this population to maintain the continuum of healthcare and improve quality.

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Significance of Preoperative Pancreatic MRI Findings in Predicting Factors for Postoperative Pancreatic Fistula after Distal Pancreatectomy for Pancreatic Cancer: A Retrospective Study

10.21203/rs.3.rs-641857/v1 ◽

2021 ◽

Author(s):

Masahiro Fukada ◽

Katsutoshi Murase ◽

Toshiya Higashi ◽

Ryoma Yokoi ◽

Hideharu Tanaka ◽

...

Keyword(s):

Pancreatic Cancer ◽

Pancreatic Fistula ◽

Distal Pancreatectomy ◽

Predictive Factors ◽

Univariate Analysis ◽

Postoperative Pancreatic Fistula ◽

University Hospital ◽

Imaging Biomarkers ◽

Mri Findings ◽

Related Factors

Abstract Background: Postoperative pancreatic fistula (POPF) is the most serious complication of distal pancreatectomy (DP). For patients with pancreatic cancer (PC), POPF can have a negative effect on both short- and long-term prognoses. This study aimed to identify clinical outcomes of POPF after DP for PC and predictive factors for POPF.Methods: This retrospective, single-institution study comprised 48 patients with PC who underwent open DP (excluding simultaneous resection of other organs and other pancreatic diseases) between January 2010 and December 2020 at the Gifu University Hospital. We statistically analyzed patient-, pancreas-, cancer-, and surgery-related factors for predicting outcomes and risk factors for POPF. Results: According to the International Study Group of Pancreatic Fistula (ISGPF) definition and grading, 11 (22.9%) of 48 patients had POPF grades B and C. Among 22 related factors, POPF was significantly associated with pancreatic width (p = 0.04) and the pancreas-to-muscle signal intensity ratio (SIR) on T1-weighted magnetic resonance imaging (MRI, p = 0.02) in univariate analysis. In multivariate analysis, both pancreatic width (≥23 mm, odds ratio [OR] 9.37; 95% confidence interval [CI] 1.22–202.40; p = 0.03) and SIR on T1-weighted MRI (≥1.37, OR 17.10; 95% CI 2.38–359.04; p = 0.003) were identified as independent predictive factors for POPF. Conclusion: Pancreatic width and pancreas-to-muscle SIR on T1-weighted MRI significantly correlated with POPF after DP for PC. These parameters may be potential imaging biomarkers for predicting POPF in pancreatic surgery.

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Preoperative Computed Tomography Imaging of the Pancreas Identifying Predictive Factors for the Progression of Grade A, or Biochemical Leak, to Grade B Postoperative Pancreatic Fistula Following Pancreaticoduodenectomy: A Retrospective Study

Medical Science Monitor ◽

10.12659/msm.928489 ◽

2020 ◽

Vol 27 ◽

Author(s):

Feng-Hao Liu ◽

Xiao-Zhong Jiang ◽

Bin Huang ◽

Yu Yu

Keyword(s):

Computed Tomography ◽

Retrospective Study ◽

Pancreatic Fistula ◽

Predictive Factors ◽

Postoperative Pancreatic Fistula ◽

Computed Tomography Imaging ◽

Tomography Imaging

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Neck Division Level and Postoperative Pancreatic Fistula After Pancreaticoduodenectomy

Case Medical Research ◽

10.31525/ct1-nct03850236 ◽

2019 ◽

Author(s):

Keyword(s):

Pancreatic Fistula ◽

Postoperative Pancreatic Fistula

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Non-operative Risk Factors and the Implications of Sandostatin for Postoperative Pancreatic Fistula in Malignant Pancreatic Surgery

Revista de Chimie ◽

10.37358/rc.17.12.5997 ◽

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.

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