A Preoperative Predictive Scoring System for Postoperative Pancreatic Fistula after Pancreaticoduodenectomy

Yamamoto, Yusuke; Sakamoto, Yoshihiro; Nara, Satoshi; Esaki, Minoru; Shimada, Kazuaki; Kosuge, Tomoo

doi:10.1007/s00268-011-1253-x

Cited by 126 publications

(121 citation statements)

References 41 publications

Supporting

Mentioning

108

Contrasting

Unclassified

Order By: Relevance

“…One studies described the development of a predictive model for POPF, based on perioperative risk factors [10]. Three studies derived a predictive model for POPF based on preoperative risk factors [8,13,17]. Intraoperative risk factors were used by one study to derive a predictive model of POPF [12].…”

Section: Resultsmentioning

confidence: 99%

“…In terms of geography, three articles were from Asia [8,17,18] and four articles were from Europe [10][11][12][13].…”

Section: Resultsmentioning

confidence: 99%

“…The median number of events about postoperative pancreatic fistula was 69 (IQR 25∼197). Five studies reported the number of events on postoperative pancreatic fistula grades based on ISGPF [5,8,11,12,18], the medium number of events on grade A 47 (IQR 6 to 76), grade B 17 (IQR 10 to 94), and grade C 8 (IQR 5 to 25). Two studies did not report the number of events on postoperative pancreatic fistula grades [10,17].…”

Section: Number Of Patients and Postoperative Pancreatic Fistulamentioning

confidence: 99%

“…Many risk factors for POPF have been identified, such as gender [8], body mass index (BMI) [9,10], status of the pancreatic parenchyma [11], diameter of the main pancreatic duct (MPD) [12], and kind of disease [13]. These risk factors lead to use some special techniques or perioperative precautions to minimize POPF rates [5,14,15].…”

Section: Introductionmentioning

confidence: 99%

See 3 more Smart Citations

Developing Risk Prediction Models for Postoperative Pancreatic Fistula: a Systematic Review of Methodology and Reporting Quality

Zhang

Guo

et al. 2016

Indian J Surg

View full text Add to dashboard Cite

Postoperative pancreatic fistula is still a major complication after pancreatic surgery, despite improvements of surgical technique and perioperative management. We sought to systematically review and critically access the conduct and reporting of methods used to develop risk prediction models for predicting postoperative pancreatic fistula. We conducted a systematic search of PubMed and EMBASE databases to identify articles published before January 1, 2015, which described the development of models to predict the risk of postoperative pancreatic fistula. We extracted information of developing a prediction model including study design, sample size and number of events, definition of postoperative pancreatic fistula, risk predictor selection, missing data, modelbuilding strategies, and model performance. Seven studies of developing seven risk prediction models were included. In three studies (42 %), the number of events per variable was less than 10. The number of candidate risk predictors ranged from 9 to 32. Five studies (71 %) reported using univariate screening, which was not recommended in building a multivariate model, to reduce the number of risk predictors. Six risk prediction models (86 %) were developed by categorizing all continuous risk predictors. The treatment and handling of missing data were not mentioned in all studies. We found use of inappropriate methods that could endanger the development of model, including univariate pre-screening of variables, categorization of continuous risk predictors, and model validation. The use of inappropriate methods affects the reliability and the accuracy of the probability estimates of predicting postoperative pancreatic fistula.

show abstract

Section: Resultsmentioning

confidence: 99%

“…In terms of geography, three articles were from Asia [8,17,18] and four articles were from Europe [10][11][12][13].…”

Section: Resultsmentioning

confidence: 99%

Section: Number Of Patients and Postoperative Pancreatic Fistulamentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Developing Risk Prediction Models for Postoperative Pancreatic Fistula: a Systematic Review of Methodology and Reporting Quality

Zhang

Guo

et al. 2016

Indian J Surg

View full text Add to dashboard Cite

show abstract

“…It is generally reported that the incidence of clinically relevant post‐operative pancreatic fistulas after PD is 7.6–36.4%,1, 2, 3, 4, 5 in accordance to the definition of the International Study Group of Pancreatic Fistula (ISGPF) 6. Researchers have suggested factors that affect pancreatic leakage after PD, including male gender, advanced age, post‐operative albumin level, intraoperative bleeding, soft pancreatic parenchyma, small pancreatic duct, drain amylase level on post‐operative day one, pancreatic parenchymal thickness and surgeon volume, among others 1, 7, 8, 9, 10, 11, 12, 13, 14…”

Section: Introductionmentioning

confidence: 99%

Division of surgeon workload in pancreaticoduodenectomy: striving to decrease post‐operative pancreatic fistula

Kim

Choi

et al. 2015

ANZ Journal of Surgery

View full text Add to dashboard Cite

BackgroundMany studies have reported factors affecting pancreatic leakage after pancreaticoduodenectomy (PD), but there have been few reports on surgeon workload and post‐operative pancreatic fistula (POPF). This study was conducted to explore whether a surgeon's workload during PD impacts the occurrence of POPF.MethodsWe retrospectively analysed 270 consecutive patients who underwent PD between January 2008 and June 2013 by a single experienced surgeon. These patients were divided into those who underwent PD entirely by a single operator (group 1) and those who received reconstructions by other operators (group 2). Duct‐to‐mucosa pancreaticojejunostomy was performed on all patients. The International Study Group on Pancreatic Fistula criteria were used to define POPF.ResultsThere were 157 patients (58.1%) in group 1 and 113 patients (41.9%) in group 2. The post‐operative morbidity rate was comparable between the two groups (55.4% versus 52.2%; P = 0.603), but the clinical pancreatic fistula (grade B/C) rate was significantly different (10.8% versus 2.7%; P = 0.011). The overall post‐operative mortality was one patient (0.4%). Significant associations were found between clinical pancreatic fistulas and soft pancreas texture (P = 0.021), preoperative serum albumin level ≤3.5 g/dL (P = 0.012), other pathology besides pancreatic cancer (P = 0.027) and a single‐operator procedure (P = 0.019). A multivariate logistic regression analysis revealed that a single operator (odds ratio: 4.2, P = 0.029) was a significant predictive risk factor for clinically relevant POPF.ConclusionDividing the surgeon's workload in PD is associated with lower rates of POPF.

show abstract

The clinical impact and risk factors of latent pancreatic fistula after pancreatoduodenectomy

Ohgi

Yamamoto

Sugiura

et al. 2020

J Hepato Biliary Pancreat

Self Cite

View full text Add to dashboard Cite

Background: Latent pancreatic fistula (LPF) is difficult to diagnose during the early postoperative phase because of initially normal drain fluid amylase (DFA) levels. The present study investigated the clinical significance and risk factors of LPF after pancreatoduodenectomy. Methods: A total of 662 patients who underwent pancreatoduodenectomy between 2010 and 2018 were retrospectively analyzed. LPF was defined as pancreatic fistula that developed later regardless of initially low DFA levels. Results: Among the 372 patients with DFA ≤375 U/L (three times the upper limit for serum) on postoperative day (POD) 3, LPF occurred in 37 (10%). The rates of postoperative hemorrhaging (11% vs 1.5%), intraabdominal abscess (57% vs 7.2%) and reintervention (46% vs 2.7%) were significantly higher in the patients with LPF than in those without LPF. A multivariate analysis revealed that a body mass index ≥25 kg/m 2 , a non-combined portal vein resection, a DFA on POD 1 ≥650 U/L and a C-reactive protein level on POD 3 ≥11 mg/dL were independent risk factors for LPF. Conclusions: Latent pancreatic fistula was significantly associated with severe complications and worse outcomes after pancreatoduodenectomy. Early drain removal may be unfavorable for patients with some of these risk factors.

show abstract

A Preoperative Predictive Scoring System for Postoperative Pancreatic Fistula after Pancreaticoduodenectomy

Abstract: The present scoring system satisfactorily predicted the occurrence of POPF and thus will be useful for the perioperative risk management of patients undergoing PD in a high-volume center hospital.

Cited by 126 publications

References 41 publications

Developing Risk Prediction Models for Postoperative Pancreatic Fistula: a Systematic Review of Methodology and Reporting Quality

Developing Risk Prediction Models for Postoperative Pancreatic Fistula: a Systematic Review of Methodology and Reporting Quality

Division of surgeon workload in pancreaticoduodenectomy: striving to decrease post‐operative pancreatic fistula

The clinical impact and risk factors of latent pancreatic fistula after pancreatoduodenectomy

Contact Info

Product

Resources

About