TY - JOUR
T1 - Bacterial smear test of drainage fluid after pancreaticoduodenectomy can predict postoperative pancreatic fistula
AU - Morimoto, Masaki
AU - Honjo, Soichiro
AU - Sakamoto, Teruhisa
AU - Yagyu, Takuki
AU - Uchinaka, Ei
AU - Amisaki, Masataka
AU - Watanabe, Joji
AU - Yamamoto, Manabu
AU - Fukumoto, Yoji
AU - Tokuyasu, Naruo
AU - Ashida, Keigo
AU - Saito, Hiroaki
AU - Fujiwara, Yoshiyuki
N1 - Funding Information:
The authors would like to thank the nurses, doctors, and other staff responsible for the patients? care at Tottori University Hospital.
Publisher Copyright:
© 2019 IAP and EPC
PY - 2019/3
Y1 - 2019/3
N2 - Objectives: It is widely accepted that postoperative pancreatic fistula (POPF) accompanied by bacterial infection results in a worse outcome than POPF alone. However, few studies evaluating predictive indicators of POPF have focused on bacterial infection. Methods: A consecutive 100 patients who underwent pancreaticoduodenectomy at our institute for periampullary disease were enrolled. POPF was assessed according to the International Study Group of Pancreatic Fistula consensus guidelines; grades B and C were defined as clinically relevant POPF (CR-POPF). The patients’ characteristics, perioperative surgical factors, and laboratory data including the results of culture and smear testing performed using drainage fluid on postoperative days (PODs) 1 and 3 were analyzed. Results: The overall incidence of CR-POPF was 25%. Univariate analyses revealed that the factors associated with CR-POPF were male sex, soft pancreas, MPD diameter, higher serum C-reactive protein concentration and white blood cell count on POD 3, higher amylase concentration in drainage fluid, and culture and/or smear positivity of drainage fluid. Multivariate analysis newly revealed that the smear positivity of drainage fluid on POD 3 was the independent risk factors for CR-POPF (p = 0.027). Conclusions: Smear positivity of drainage fluid on POD 3 after pancreaticoduodenectomy may be a new predictor of CR-POPF.
AB - Objectives: It is widely accepted that postoperative pancreatic fistula (POPF) accompanied by bacterial infection results in a worse outcome than POPF alone. However, few studies evaluating predictive indicators of POPF have focused on bacterial infection. Methods: A consecutive 100 patients who underwent pancreaticoduodenectomy at our institute for periampullary disease were enrolled. POPF was assessed according to the International Study Group of Pancreatic Fistula consensus guidelines; grades B and C were defined as clinically relevant POPF (CR-POPF). The patients’ characteristics, perioperative surgical factors, and laboratory data including the results of culture and smear testing performed using drainage fluid on postoperative days (PODs) 1 and 3 were analyzed. Results: The overall incidence of CR-POPF was 25%. Univariate analyses revealed that the factors associated with CR-POPF were male sex, soft pancreas, MPD diameter, higher serum C-reactive protein concentration and white blood cell count on POD 3, higher amylase concentration in drainage fluid, and culture and/or smear positivity of drainage fluid. Multivariate analysis newly revealed that the smear positivity of drainage fluid on POD 3 was the independent risk factors for CR-POPF (p = 0.027). Conclusions: Smear positivity of drainage fluid on POD 3 after pancreaticoduodenectomy may be a new predictor of CR-POPF.
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U2 - 10.1016/j.pan.2019.01.018
DO - 10.1016/j.pan.2019.01.018
M3 - Article
C2 - 30718188
AN - SCOPUS:85060870547
VL - 19
SP - 274
EP - 279
JO - Pancreatology
JF - Pancreatology
SN - 1424-3903
IS - 2
ER -