Postoperative Pancreatic Fistula
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Recent papers in Postoperative Pancreatic Fistula
Background/Objective: Postoperative pancreatic fistula (POPF) remains an important cause of morbidity and mortality after pancreaticoduodenectomy. Pancreaticogastrost-omy (PG) as a reconstruction method after pancreaticoduodenectomy is a... more
Background/Objective: Postoperative pancreatic fistula (POPF) remains an important cause of morbidity and mortality after pancreaticoduodenectomy. Pancreaticogastrost-omy (PG) as a reconstruction method after pancreaticoduodenectomy is a safe and optional surgical technique in decreasing the risk of POPF. In this study, a retrospective analysis was carried out to evaluate a new modification of PG technique that uses a two-layer anastomoses with an internal stent.
Methods: Forty-seven patients underwent this newly modified PG technique between February 2012 and August 2016. Demographics, histopathological findings, type of surgery performed, perioperative parameters, postoperative length of stay, postoperative complications and interventional procedures, follow-up, and mortality data were collected and analyzed. Clavien-Dindo classification was used to grade the complications' severity.
Results: Postoperative mortality was 4.25%, unrelated to POPF, and postoperative morbidity was 44.68%. Thirteen patients had severe (>Grade IIIa) complications, according to ClavieneDindo classification. As classified in accordance to the International Study Group of Pancreatic Fistula, 24 (51.06%) patients developed Grade A POPF, and no occurrence of Grade B/C POPF was noted. All patients recovered uneventfully with successful treatment interventions.
Conclusion: The reported PG anastomotic technique is a safe and dependable reconstruction procedure with acceptable morbidity and mortality.
Methods: Forty-seven patients underwent this newly modified PG technique between February 2012 and August 2016. Demographics, histopathological findings, type of surgery performed, perioperative parameters, postoperative length of stay, postoperative complications and interventional procedures, follow-up, and mortality data were collected and analyzed. Clavien-Dindo classification was used to grade the complications' severity.
Results: Postoperative mortality was 4.25%, unrelated to POPF, and postoperative morbidity was 44.68%. Thirteen patients had severe (>Grade IIIa) complications, according to ClavieneDindo classification. As classified in accordance to the International Study Group of Pancreatic Fistula, 24 (51.06%) patients developed Grade A POPF, and no occurrence of Grade B/C POPF was noted. All patients recovered uneventfully with successful treatment interventions.
Conclusion: The reported PG anastomotic technique is a safe and dependable reconstruction procedure with acceptable morbidity and mortality.
A retrospective cohort study that aimed to derive a cut off value of the drain fluid amylase (DFA) to predict high grade pancreatic fistula (CSPF) according to the International Study Group of Pancreatic Surgery guidelines and to evaluate... more
A retrospective cohort study that aimed to derive a cut off value of the drain fluid amylase (DFA) to predict high grade pancreatic fistula (CSPF) according to the International Study Group of Pancreatic Surgery guidelines and to evaluate its association with the length of hospital stay. 115 patients who underwent pancreaticoduodenectomy over a year’s period were identified. The DFA median for CSPF was 381.5 and for the group with PFA and without pancreatic fistula (NPF) was 22.5 (p<0.0001). Patients with CSPF had a more complicated post-operative period (p<0.05) and prolonged hospital stay(p<0.001). A DFA value of 109 had a sensitivity of 72.2% and specificity of 89.4% (p<0.05) in predicting CSPF and the area under the ROC curve was calculated as 0.859. In conclusion, this study demonstrates the potential utility of the DFA value in predicting the risk of CSPF and its association with prolonged hospital stay.