Pre-, peri- and post-operative factors for the development of pancreatic fistula after pancreatic surgery

Søreide, Kjetil; Healey, Andrew J.; Mole, Damian J.; Parks, Rowan W.

doi:10.1016/j.hpb.2019.06.004

Cited by 44 publications

(38 citation statements)

References 84 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…The hard pancreatic structure due to the peritumoral fibrous tissue is thought to reduce the risk of pancreatic fistulas for patients with pancreatic ductal adenocarcinomas [22], but this was not confirmed in our study group, where there were no statistically significant differences in distribution of peritumoral fibrous tissue depending on histological diagnosis.…”

Section: Discussioncontrasting

confidence: 71%

Protective or Risk Factors for Postoperative Pancreatic Fistulas in Malignant Pathology

Vasilescu

Rusu

Bradea

et al. 2021

Life

View full text Add to dashboard Cite

Introduction: Malignant tumors are associated with a low incidence of postoperative pancreatic fistulas. The presence of peritumoral fibrosis is considered the protective factor for the development of postoperative pancreatic fistulas after pancreatic resections for pancreatic ductal adenocarcinomas. Methods: We analyzed a series of 109 consecutive patients with pancreatic resections for malignant pathology: pancreatic ductal adenocarcinomas and periampullary adenocarcinomas. The incidence of postoperative pancreatic fistulas has been reported in tumor histological type, in the presence of peritumoral fibrosis, and in the association between adenocarcinomas and areas of acute pancreatitis. The data obtained were processed with the statistical analysis program SPSS, and statistically significant p were considered at a value <0.05. Results: For the entire study group, the incidence of postoperative pancreatic fistulas was 11.01%. The lowest incidence was observed in the group of patients with pancreatic ductal adenocarcinomas (4.06% vs. 25.72% in the group with periampullary adenocarcinoma), with a p = 0.002. The presence of peritumoral fibrous tissue was observed in 49.31% of cases without pancreatic fistulas, and in 54.54% of cases that developed this postoperative complication (p = 0.5). Also, the peritumoral fibrous tissue had a uniform distribution depending on the main diagnosis (56.14% in pancreatic ductal adenocarcinoma group vs. 37.04% in periampullary adenocarcinoma group, with a p = 0.08). In the group of patients who associated areas of acute pancreatitis on the resections, the incidence of postoperative pancreatic fistulas was 7.8 times higher (30% vs. 3.8%, p = 0.026). Conclusions: Peritumoral fibrous tissue was not a factor involved in the developing of postoperative pancreatic fistulas. The association of adenocarciomas with areas of acute pancreatitis has led to a significant increase in postoperative pancreatic fistulas, which is a significant and independent risk factor.

show abstract

Section: Discussioncontrasting

confidence: 71%

Protective or Risk Factors for Postoperative Pancreatic Fistulas in Malignant Pathology

Vasilescu

Rusu

Bradea

et al. 2021

Life

View full text Add to dashboard Cite

show abstract

“…As it is the most common complication, avoiding it is the strategy to follow. In a review, Søreide et al 23 associated fistula with acute pancreatitis, complication of underlying diseases, malnutrition and surgical site infection. This study revealed the development of GED as a consequence of malnutrition followed by fistulas and formation of intra-abdominal collections.…”

Section: Discussionmentioning

confidence: 99%

What Factors Contribute to Delayed Gastric Emptying After Duodenopancreatectomy With Piloric Preservation?

Nishio

Pacheco

Moricz

et al. 2021

ABCD, arq. bras. cir. dig.

View full text Add to dashboard Cite

Background: The delay in gastric emptying is the second most frequent complication after duodenopancreatectomy with pyloric preservation, that increases hospitalization time and hospital costs. Aim: To identify factors that contribute to the appearance the delay in this surgical procedure. Method: Ninety-five patients were submitted to duodenopancreatectomy with pyloric preservation. After retrospective analysis of the medical records, it was observed that 60 had prolonged hospitalization due to complications. Thus, univariate and multivariate logistic regression were used to analyze predictors of delayed gastric emptying. Results: Delay was present in 65% (n=39) and pancreatic fistula in 38.3% (n=23). Univariate analysis revealed that the presence of pancreatic complications (pancreatic fistula, p=0.01), other intracavitary complications with the appearance of abdominal collections (p=0.03) and hypoalbuminemia (p=0.06) were responsible, also confirmed by the multivariate analysis. In those who presented delay without a determined cause, it was observed that high levels of total bilirubin (p=0.01) and direct bilirubin (p=0.01) could be related to it. Conclusion: The delay in gastric emptying in patients undergoing duodenopancreatectomy with pyloric preservation is due to intracavitary complications.

show abstract

“…Attention should be paid to the pathology of POPF. It has been reported that pancreatic fistula may be related to following aspects: [22][23][24] (1) When tissue and tissue are anastomosed, the needle passes through the pancreatic tissue and may break through the expanded small pancreatic duct, which may also cause pinhole infiltration, thereby causing leakage of pancreatic juice; (2) When the pancreas and intestine are anastomosed, there must be a gap between the needles, which causes pancreatic juice to leak out from the gap; (3) There is high pressure in the jejunal intestine tube. At the end of surgery, if the intestines cannot work normally and peristalsis is weak, and there is a long jejunal bridge after co-operating with the pancreas, this can easily cause pancreatic juice and bile retention in the intestine.…”

Section: Discussionmentioning

confidence: 99%

Analysis of pancreatic fistula risk in patients with laparoscopic pancreatoduodenectomy: what matters

et al. 2020

View full text Add to dashboard Cite

Objective To analyse potential risk factors for postoperative pancreatic fistula (POPF). Methods A retrospective study on risk factors for POPF was conducted in patients undergoing laparoscopic pancreatoduodenectomy. Basic characteristics, and preoperative, intraoperative and postoperative patient data were collected and analysed. Results A total of 268 patients were enrolled in this study, including 54 patients with POPF following surgery (POPF incidence, 20.15%). Univariate analysis indicated that patient’s age, body mass index (BMI), preoperative bilirubin level, pancreas texture, and drainage fluid amylase level on day 1 following surgery were associated with POPF. Multiple logistic regression analysis indicated that preoperative bilirubin level ≥170 µmol/l, soft pancreas texture, BMI ≥25, and age ≥65 years were independent risk factors associated with POPF. Conclusions For patients with preoperative bilirubin level ≥170 µmol/l, soft pancreas texture, BMI ≥25 and age ≥65 years, clinically relevant measures should be taken as early as possible for the prophylaxis of POPF.

show abstract

Pre-, peri- and post-operative factors for the development of pancreatic fistula after pancreatic surgery

Cited by 44 publications

References 84 publications

Protective or Risk Factors for Postoperative Pancreatic Fistulas in Malignant Pathology

Protective or Risk Factors for Postoperative Pancreatic Fistulas in Malignant Pathology

What Factors Contribute to Delayed Gastric Emptying After Duodenopancreatectomy With Piloric Preservation?

Analysis of pancreatic fistula risk in patients with laparoscopic pancreatoduodenectomy: what matters

Contact Info

Product

Resources

About