Risk Factors for Pancreatic Fistula. Does It Have a Clinical Application for Early Identification of Patients With High Risk to Develop Pancreatic Fistula After Pancreaticoduodenectomy?

Matheus, A. S.; Montagnini, Andr L.; Jukemura, J; Jureidini, Ricardo; Perini, Marcos; Penteado, Sonia; Haddad, Luciana Bertocco de Paiva; Abdo, E. E.; Cunha, J.E.M.

doi:10.1097/00006676-200611000-00153

Cited by 4 publications

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“…There is an extensive literature illustrating many predictive factors for POPF development, classified as patient-related, operative, and gland-related factors [15–17]. …”

Section: Discussionmentioning

confidence: 99%

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Morphohistological Features of Pancreatic Stump Are the Main Determinant of Pancreatic Fistula after Pancreatoduodenectomy

Ridolfi

Angiolini

Gavazzi

et al. 2014

BioMed Research International

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Introduction. Pancreatic surgery is challenging and associated with high morbidity, mainly represented by postoperative pancreatic fistula (POPF) and its further consequences. Identification of risk factors for POPF is essential for proper postoperative management. Aim of the Study. Evaluation of the role of morphological and histological features of pancreatic stump, other than main pancreatic duct diameter and glandular texture, in POPF occurrence after pancreaticoduodenectomy. Patients and Methods. Between March 2011 and April 2013, we performed 145 consecutive pancreaticoduodenectomies. We intraoperatively recorded morphological features of pancreatic stump and collected data about postoperative morbidity. Our dedicated pathologist designed a score to quantify fibrosis and inflammation of pancreatic tissue. Results. Overall morbidity was 59,3%. Mortality was 4,1%. POPF rate was 28,3%, while clinically significant POPF were 15,8%. Male sex (P = 0.009), BMI ≥ 25 (P = 0.002), prolonged surgery (P = 0.001), soft pancreatic texture (P < 0.001), small pancreatic duct (P < 0.001), pancreatic duct decentralization on stump anteroposterior axis, especially if close to the posterior margin (P = 0.031), large stump area (P = 0.001), and extended stump mobilization (P = 0.001) were related to higher POPF rate. Our fibrosis-and-inflammation score is strongly associated with POPF (P = 0.001). Discussion and Conclusions. Pancreatic stump features evaluation, including histology, can help the surgeon in fitting postoperative management to patient individual risk after pancreaticoduodenectomy.

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“…There is an extensive literature illustrating many predictive factors for POPF development, classified as patient-related, operative, and gland-related factors [15–17]. …”

Section: Discussionmentioning

confidence: 99%

“…Pancreatic fistula is the “Achilles' heel” of pancreatoduodenectomy, as it represents the major cause of morbidity. There is an extensive literature illustrating many predictive factors for POPF development, classified as patient-related, operative, and gland-related factors [ 15 – 17 ].…”

Section: Discussionmentioning

confidence: 99%

Morphohistological Features of Pancreatic Stump Are the Main Determinant of Pancreatic Fistula after Pancreatoduodenectomy

Ridolfi

Angiolini

Gavazzi

et al. 2014

BioMed Research International

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“…Subjective evaluation of the greater consistency of the pancreas, associated with ductal dilatation, contributed to a lower incidence of pancreatic fistulas [14] .…”

Section: Discussionmentioning

confidence: 99%

Surgical Treatment Modalities, Mortality and Morbidity in Pancreatic Cancer Patients in Misurata Cancer Center

Elamyal¹

2018

jmscr

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“…Among the local factors related to the genesis of pancreatic fistulas, the consistency of the pancreatic remnant (soft, normal or hard) and the caliber of the pancreatic ducts are noteworthy. Subjective evaluation of the greater consistency of the pancreas, associated with ductal dilatation, contributed to a lower incidence of pancreatic fistulas 23 . In the indicated study, this complication was unrelated to the consistency of the gland or to the type of anastomosis used (duct-to-mucosa or telescoping of the pancreatic stump).…”

Section: Discussionmentioning

confidence: 99%

Morbidity and mortality of pancreatic tumors undergoing surgical treatment

Zeni¹,

Russi²,

Fialho³

et al. 2014

ABCD, arq. bras. cir. dig.

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BackgroundPancreatic cancer has a high mortality rate due to late diagnosis and aggressive behavior. The prognosis is poor, with 5-year survival occurring in less than 5% of cases.AimTo analyze demographic characteristics, comorbidities, type of procedure and early postoperative complications of patients with pancreatic cancer submitted to surgical treatment.MethodsCross-sectional study with analysis of 28 medical records of patients with malignant tumors of the pancreas in a 62 month. Data collection was performed from the medical records of the hospital.ResultsOf the total, 53,6% were male and the mean age was 60.25 years. According to the procedure, 53,6% was submitted to duodenopancreactectomy the remainder to biliodigestive derivation or distal pancreatectomy. The ductal adenocarcinoma occurred in 82,1% and 92,9% of tumors were located in the pancreatic head. Early postoperative complications occurred in 64,3% of cases and the most prevalent was intra-abdominal abscess (32,1%). Among duodenopancreactectomies 77,8% had early postoperative complications.ConclusionIts necessary to encourage early detection of tumors of the pancreas to raise the number operations with curative intent. Refinements in surgical techniques and surgical teams can diminish postoperative complications and, so, operative morbimortality can also decrease over time.

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Risk Factors for Pancreatic Fistula. Does It Have a Clinical Application for Early Identification of Patients With High Risk to Develop Pancreatic Fistula After Pancreaticoduodenectomy?

Cited by 4 publications

References 0 publications

Morphohistological Features of Pancreatic Stump Are the Main Determinant of Pancreatic Fistula after Pancreatoduodenectomy

Morphohistological Features of Pancreatic Stump Are the Main Determinant of Pancreatic Fistula after Pancreatoduodenectomy

Surgical Treatment Modalities, Mortality and Morbidity in Pancreatic Cancer Patients in Misurata Cancer Center

Morbidity and mortality of pancreatic tumors undergoing surgical treatment

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