Predictive risk factors for clinically relevant pancreatic fistula analyzed in 1,239 patients with pancreaticoduodenectomy: multicenter data collection as a project study of pancreatic surgery by the Japanese Society of Hepato-Biliary-Pancreatic Surgery

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 eval...

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Published in:Journal of hepato-biliary-pancreatic sciences 2011-07, Vol.18 (4), p.601-608
Main Authors: Kawai, Manabu, Kondo, Satoshi, Yamaue, Hiroki, Wada, Keita, Sano, Keiji, Motoi, Fuyuhiko, Unno, Michiaki, Satoi, Sohei, Kwon, A-Hon, Hatori, Takashi, Yamamoto, Masakazu, Matsumoto, Joe, Murakami, Yoshiaki, Doi, Ryuichiro, Ito, Masahiro, Miyakawa, Shuichi, Shinchi, Hiroyuki, Natsugoe, Shoji, Nakagawara, Hisatoshi, Ohta, Tetsuo, Takada, Tadahiro
Format: Article
Language:English
Subjects:
Abdominal Surgery
Aged
Clinical outcomes
Data Collection
Digestive System Neoplasms - surgery
drain amylase level
Female
Follow-Up Studies
Gastroenterology
Hepatology
Humans
Incidence
Japan - epidemiology
Male
Medicine
Medicine & Public Health
Original Article
pancreatic fistula
Pancreatic Fistula - epidemiology
Pancreatic Fistula - etiology
pancreaticoduodenectomy
Pancreaticoduodenectomy - adverse effects
Postoperative Complications
predictive risk factors
Reproducibility of Results
Retrospective Studies
Risk Factors
ROC Curve
Societies, Medical
Society
Surgery
Surgical Oncology
Surveys and Questionnaires
Survival Rate - trends
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Summary: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  
ISSN:1868-6974
1868-6982
DOI:10.1007/s00534-011-0373-x