TY - JOUR
T1 - Predictive risk factors for clinically relevant pancreatic fistula analyzed in 1,239 patients with pancreaticoduodenectomy
T2 - Multicenter data collection as a project study of pancreatic surgery by the Japanese Society of Hepato-Biliary-Pancreatic Surgery
AU - Kawai, Manabu
AU - Kondo, Satoshi
AU - Yamaue, Hiroki
AU - Wada, Keita
AU - Sano, Keiji
AU - Motoi, Fuyuhiko
AU - Unno, Michiaki
AU - Satoi, Sohei
AU - Kwon, A. Hon
AU - Hatori, Takashi
AU - Yamamoto, Masakazu
AU - Matsumoto, Joe
AU - Murakami, Yoshiaki
AU - Doi, Ryuichiro
AU - Ito, Masahiro
AU - Miyakawa, Shuichi
AU - Shinchi, Hiroyuki
AU - Natsugoe, Shoji
AU - Nakagawara, Hisatoshi
AU - Ohta, Tetsuo
AU - Takada, Tadahiro
PY - 2011/7
Y1 - 2011/7
N2 - Background/purpose It is important to predict the development of clinically relevant pancreatic fistula (grade B/C) in the early period after pancreaticoduodenectomy (PD). This study has been carried out as a project study of the Japanese Society of Hepato-Biliary-Pancreatic Surgery (JSHPBS) to evaluate the predictive factors associated with clinically relevant pancreatic fistula (grade B/C). Method The data of 1,239 patients from 11 medical institutions who had undergone PD between July 2005 and June 2009 were retrospectively analyzed to review patient characteristics and perioperative and postoperative parameters. Results A drain amylase level [4,000 IU/L on postoperative day (POD) 1 was proposed as the cut-off level to predict clinical relevant pancreatic fistula by the receiver operating characteristic (ROC) curve. The sensitivity, specificity, and accuracy of this cut-off level were 62.2, 89.0, and 84.8%, respectively. A multivariate logistic regression analysis revealed that male [odds ratio (OR) 1.7, P = 0.039], intraoperative bleeding [1,000 ml (OR 2.5, P = 0.001), soft pancreas (OR 2.7, P = 0.001), and drain amylase level on POD 1[4,000 IU/L (OR 8.6, P<0.001) were the significant predictive factors for clinical pancreatic fistula. Conclusion The four predictive risk factors identified here can provide useful information useful for tailoring postoperative management of clinically relevant pancreatic fistula (grade B/C).
AB - Background/purpose It is important to predict the development of clinically relevant pancreatic fistula (grade B/C) in the early period after pancreaticoduodenectomy (PD). This study has been carried out as a project study of the Japanese Society of Hepato-Biliary-Pancreatic Surgery (JSHPBS) to evaluate the predictive factors associated with clinically relevant pancreatic fistula (grade B/C). Method The data of 1,239 patients from 11 medical institutions who had undergone PD between July 2005 and June 2009 were retrospectively analyzed to review patient characteristics and perioperative and postoperative parameters. Results A drain amylase level [4,000 IU/L on postoperative day (POD) 1 was proposed as the cut-off level to predict clinical relevant pancreatic fistula by the receiver operating characteristic (ROC) curve. The sensitivity, specificity, and accuracy of this cut-off level were 62.2, 89.0, and 84.8%, respectively. A multivariate logistic regression analysis revealed that male [odds ratio (OR) 1.7, P = 0.039], intraoperative bleeding [1,000 ml (OR 2.5, P = 0.001), soft pancreas (OR 2.7, P = 0.001), and drain amylase level on POD 1[4,000 IU/L (OR 8.6, P<0.001) were the significant predictive factors for clinical pancreatic fistula. Conclusion The four predictive risk factors identified here can provide useful information useful for tailoring postoperative management of clinically relevant pancreatic fistula (grade B/C).
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U2 - 10.1007/s00534-011-0373-x
DO - 10.1007/s00534-011-0373-x
M3 - Review article
C2 - 21491103
AN - SCOPUS:80052680151
SN - 1868-6974
VL - 18
SP - 601
EP - 608
JO - Journal of Hepato-Biliary-Pancreatic Sciences
JF - Journal of Hepato-Biliary-Pancreatic Sciences
IS - 4
ER -