TY - JOUR
T1 - Risk factors for pancreatic fistula grade C after pancreatoduodenectomy
T2 - A large prospective, multicenter Japan-Taiwan collaboration study
AU - Hirono, Seiko
AU - Shimokawa, Toshio
AU - Nagakawa, Yuichi
AU - Shyr, Yi Ming
AU - Kawai, Manabu
AU - Matsumoto, Ippei
AU - Satoi, Sohei
AU - Yoshitomi, Hideyuki
AU - Okabayashi, Takehiro
AU - Motoi, Fuyuhiko
AU - Amano, Ryosuke
AU - Murakami, Yoshiaki
AU - Hirano, Satoshi
AU - Kawamoto, Kazuyuki
AU - Nakamori, Shoji
AU - Shan, Yan Shen
AU - Kobayashi, Shinjiro
AU - Nitta, Hiroyuki
AU - Matsukawa, Hiroyoshi
AU - Uchiyama, Kazuhisa
AU - Hsu, Chih Po
AU - Kitami, Chie
AU - Yamamoto, Masakazu
AU - Hwang, Tsann Long
AU - Yamaue, Hiroki
N1 - Funding Information:
This study was supported by the Japanese Society of Hepato‐Biliary‐Pancreatic Surgery and Taiwan Society of Gastrointestinal Surgery. The authors thank their colleagues who contributed to data collection for this study: Sadatoshi Shimizu (Osaka City General Hospital), Toshiyuki Natsume (Funabashi Municipal Medical Center), Hiroshi Yokomizo (Japanese Red Cross Kumamoto Hospital), Yasutoshi Kimura (Sapporo Medical University), Yutaka Suzuki (Kyorin University), Masaji Tani (Shiga University), Masayuki Ohta (Oita University), Tomonari Ishimine (Urasoe General Hospital), Yhuji Isaji (Mie University), Akira Kenjo (Fukushima Medical University), Susumu Eguchi (Nagasaki University), Masaru Inagaki (Fukuyama Medical Center), Kyohei Kai (Japanese Red Cross Society Himeji Hospital), Eiichi Tanaka (Hokkaido Gastroenterology Hospital), Hitoshi Sekido (Yokohama Medical Center), Toshifumi Wakai (Niigata University), Akihiko Horiguchi (Fujita Health University), Yasuhiro Shimizu (Aichi Cancer Center), Hideki Aoki (Iwakuni Clinical Center), Yasuhiro Matsugu (Hiroshima Prefectural Hospital), Shin Takeda (Nagoya Medical Center), Tsutomu Fujii (Nagoya University), Keita Wada (Teikyo University), Masahiko Kawamoto (JCHO Kyushu Hospital), Masayuki Sho (Nara Medical University), Yutaka Takeda (Kansai Rosai Hospital), Masaki Kajikawa (Gifu Prefectural Tajimi Hospital), Shinji Osada (Gifu University), Norihiro Kokudo (University of Tokyo), Yoshiharu Nakamura (Nippon Medical School), Masaya Oikawa (Sendai Medical Center), Tatsuya Hayashi (Tokyo Metropolitan Tama Medical Center), Toshihiko Masui (Kyoto University), Kazuhisa Arakawa (Japanese Red Cross Maebashi Hospital), Itaru Endo (Yokohama City University), Satoshi Kobayashi (Shinshu University), Takahito Adachi (Gifu Municipal Hospital), Makoto Yoshida (Kin‐ikyo Chuo Hospital), Junichi Matsui (Tokyo Dental College Ichikawa General Hospital), Shoji Kubo (Osaka City University, Graduate School of Medicine), Kenichi Hakamada (Hirosaki University), Kosei Maemura (Kagoshima University), Takeshi Sudo (Kure Medical Center), Munenori Tahara (Sapporo‐Kosei General Hospital), Junzo Shimizu (Osaka Rosai Hospital), Saiho Ko (Nara Prefecture General Medical Center), Daisuke Kato (Fukuoka University), Keiichi Okano (Kagawa University), Yoshinobu Sato (Showa University Yokohama Northern Hospital). We also acknowledge proofreading and editing by Benjamin Phillis.
PY - 2020/9/1
Y1 - 2020/9/1
N2 - Background/Purpose: Grade C postoperative pancreatic fistula (POPF), as defined by International Study Group of Pancreatic Fistula (ISGPF), is the most life-threatening complication after pancreatoduodenectomy (PD). This study aims to evaluate risk factors for Grade C POPF after PD. Methods: This is a prospective, multicenter study based in Japan and Taiwan. Between December 2014 and May 2017, 3022 patients were enrolled in this study and 2762 patients were analyzed. We analyzed risk factors of Grade C POPF based on the updated 2016 ISGPF scheme (organ failure, reoperation, and/or death). Results: Among 2762 patients, 46 patients (1.7%) developed Grade C POPF after PD. The mortality rate of the 46 patients with Grade C POPF was 37.0%. On the multivariate analysis, six independent risk factors for Grade C POPF were found; BMI ≥ 25.0 kg/m2, chronic steroid use, preoperative serum albumin <3.0 mg/dL, soft pancreas, operative time ≥480 minutes, and intraoperative transfusion. The c-statistic of our risk scoring model for Grade C POPF using these risk factors was 0.77. The score was significantly higher in Grade C POPF than in Grade B POPF (P <.001) or none/biochemical leak (P <.001). Conclusions: This prospective study showed risk factors for Grade C POPF after PD.
AB - Background/Purpose: Grade C postoperative pancreatic fistula (POPF), as defined by International Study Group of Pancreatic Fistula (ISGPF), is the most life-threatening complication after pancreatoduodenectomy (PD). This study aims to evaluate risk factors for Grade C POPF after PD. Methods: This is a prospective, multicenter study based in Japan and Taiwan. Between December 2014 and May 2017, 3022 patients were enrolled in this study and 2762 patients were analyzed. We analyzed risk factors of Grade C POPF based on the updated 2016 ISGPF scheme (organ failure, reoperation, and/or death). Results: Among 2762 patients, 46 patients (1.7%) developed Grade C POPF after PD. The mortality rate of the 46 patients with Grade C POPF was 37.0%. On the multivariate analysis, six independent risk factors for Grade C POPF were found; BMI ≥ 25.0 kg/m2, chronic steroid use, preoperative serum albumin <3.0 mg/dL, soft pancreas, operative time ≥480 minutes, and intraoperative transfusion. The c-statistic of our risk scoring model for Grade C POPF using these risk factors was 0.77. The score was significantly higher in Grade C POPF than in Grade B POPF (P <.001) or none/biochemical leak (P <.001). Conclusions: This prospective study showed risk factors for Grade C POPF after PD.
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U2 - 10.1002/jhbp.799
DO - 10.1002/jhbp.799
M3 - Article
C2 - 32621787
AN - SCOPUS:85089106009
VL - 27
SP - 622
EP - 631
JO - Journal of Hepato-Biliary-Pancreatic Sciences
JF - Journal of Hepato-Biliary-Pancreatic Sciences
SN - 1868-6974
IS - 9
ER -