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 - Publisher Copyright:
© 2020 Japanese Society of Hepato-Biliary-Pancreatic Surgery
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.
UR - https://www.scopus.com/pages/publications/85089106009
UR - https://www.scopus.com/pages/publications/85089106009#tab=citedBy
U2 - 10.1002/jhbp.799
DO - 10.1002/jhbp.799
M3 - Article
C2 - 32621787
AN - SCOPUS:85089106009
SN - 1868-6974
VL - 27
SP - 622
EP - 631
JO - Journal of Hepato-Biliary-Pancreatic Sciences
JF - Journal of Hepato-Biliary-Pancreatic Sciences
IS - 9
ER -