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Facing the surgeon's nightmare: Incidence and management of postoperative pancreatic fistulas grade C after pancreaticoduodenectomy based on the updated definition of the International Study Group of Pancreatic Surgery (ISGPS)
Background Postoperative pancreatic fistulas (POPF) grade C represent a rare but feared complication following pancreaticoduodenectomy (PD). They can contribute significantly to postoperative morbidity and mortality. Methods We performed a retrospective chart review for all patients who had undergon...
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| Published in: | Journal of hepato-biliary-pancreatic sciences 2020-04, Vol.27 (4), p.171-181 |
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| container_issue | 4 |
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| container_title | Journal of hepato-biliary-pancreatic sciences |
| container_volume | 27 |
| creator | Luu, Andreas Minh Krasemann, Lukas Fahlbusch, Tim Belyaev, Orlin Janot‐Matuschek, Monika Uhl, Waldemar Braumann, Chris |
| description | Background
Postoperative pancreatic fistulas (POPF) grade C represent a rare but feared complication following pancreaticoduodenectomy (PD). They can contribute significantly to postoperative morbidity and mortality.
Methods
We performed a retrospective chart review for all patients who had undergone pancreatic head resection between 2007 and 2016 to identify those who suffered from POPF grade C according to the updated definition of the International Study Group of Pancreatic Surgery (ISGPS).
Results
A total of 722 patients underwent PD. Twenty‐three patients (3.19%) developed a POPF grade C. Cardiovascular diseases, soft pancreatic texture and main pancreatic duct diameter were identified as risk factors (P |
| doi_str_mv | 10.1002/jhbp.713 |
| format | article |
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Postoperative pancreatic fistulas (POPF) grade C represent a rare but feared complication following pancreaticoduodenectomy (PD). They can contribute significantly to postoperative morbidity and mortality.
Methods
We performed a retrospective chart review for all patients who had undergone pancreatic head resection between 2007 and 2016 to identify those who suffered from POPF grade C according to the updated definition of the International Study Group of Pancreatic Surgery (ISGPS).
Results
A total of 722 patients underwent PD. Twenty‐three patients (3.19%) developed a POPF grade C. Cardiovascular diseases, soft pancreatic texture and main pancreatic duct diameter were identified as risk factors (P < .05). Reoperation was necessary in all affected patients on postoperative day 12 ± 9 on average. Mortality was significantly associated with POPF grade C (P < .05) being present in 39.1% (9/23).
Conclusions
POPF grade C after PD remains a serious complication with a high level of morbidity and mortality. Surgical treatment is the sole curative therapy and thus the treatment of choice.
Highlight
Postoperative pancreatic fistulas grade C are a rare complication contributing significantly to postoperative morbidity and mortality. Completion pancreatectomy is the sole curative therapy which must be initiated as quickly as possible.</description><identifier>ISSN: 1868-6974</identifier><identifier>EISSN: 1868-6982</identifier><identifier>DOI: 10.1002/jhbp.713</identifier><identifier>PMID: 31951086</identifier><language>eng</language><publisher>Japan: Wiley Subscription Services, Inc</publisher><subject>Adolescent ; Adult ; Aged ; Aged, 80 and over ; Anastomosis, Surgical - adverse effects ; Anastomosis, Surgical - methods ; Female ; Fistula ; Germany - epidemiology ; Humans ; Incidence ; International Study Group of Pancreatic Surgery ; Jejunum - surgery ; Male ; Middle Aged ; Mortality ; Pancreas - surgery ; Pancreatic Diseases - etiology ; Pancreatic Diseases - mortality ; Pancreatic Diseases - surgery ; Pancreatic Ducts - surgery ; Pancreatic Fistula - classification ; Pancreatic Fistula - epidemiology ; Pancreatic Fistula - mortality ; Pancreatic Fistula - surgery ; Pancreaticoduodenectomy ; Pancreaticoduodenectomy - adverse effects ; Pancreaticoduodenectomy - methods ; postoperative pancreatic fistula ; Reoperation ; Retrospective Studies ; Risk Assessment ; Risk Factors ; Stomach - surgery ; Treatment Outcome ; Whipple's procedure ; Young Adult</subject><ispartof>Journal of hepato-biliary-pancreatic sciences, 2020-04, Vol.27 (4), p.171-181</ispartof><rights>2020 Japanese Society of Hepato‐Biliary‐Pancreatic Surgery</rights><rights>2020 Japanese Society of Hepato-Biliary-Pancreatic Surgery.</rights><rights>2020. This article is published under http://creativecommons.org/licenses/by/4.0/ (the “License”). Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c4733-308d42cd272ad157a9c4e13dae031463c164051a6aa802a9a6db6f157d4da9733</citedby><cites>FETCH-LOGICAL-c4733-308d42cd272ad157a9c4e13dae031463c164051a6aa802a9a6db6f157d4da9733</cites><orcidid>0000-0001-8981-8973</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,780,784,27924,27925</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/31951086$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Luu, Andreas Minh</creatorcontrib><creatorcontrib>Krasemann, Lukas</creatorcontrib><creatorcontrib>Fahlbusch, Tim</creatorcontrib><creatorcontrib>Belyaev, Orlin</creatorcontrib><creatorcontrib>Janot‐Matuschek, Monika</creatorcontrib><creatorcontrib>Uhl, Waldemar</creatorcontrib><creatorcontrib>Braumann, Chris</creatorcontrib><title>Facing the surgeon's nightmare: Incidence and management of postoperative pancreatic fistulas grade C after pancreaticoduodenectomy based on the updated definition of the International Study Group of Pancreatic Surgery (ISGPS)</title><title>Journal of hepato-biliary-pancreatic sciences</title><addtitle>J Hepatobiliary Pancreat Sci</addtitle><description>Background
Postoperative pancreatic fistulas (POPF) grade C represent a rare but feared complication following pancreaticoduodenectomy (PD). They can contribute significantly to postoperative morbidity and mortality.
Methods
We performed a retrospective chart review for all patients who had undergone pancreatic head resection between 2007 and 2016 to identify those who suffered from POPF grade C according to the updated definition of the International Study Group of Pancreatic Surgery (ISGPS).
Results
A total of 722 patients underwent PD. Twenty‐three patients (3.19%) developed a POPF grade C. Cardiovascular diseases, soft pancreatic texture and main pancreatic duct diameter were identified as risk factors (P < .05). Reoperation was necessary in all affected patients on postoperative day 12 ± 9 on average. Mortality was significantly associated with POPF grade C (P < .05) being present in 39.1% (9/23).
Conclusions
POPF grade C after PD remains a serious complication with a high level of morbidity and mortality. Surgical treatment is the sole curative therapy and thus the treatment of choice.
Highlight
Postoperative pancreatic fistulas grade C are a rare complication contributing significantly to postoperative morbidity and mortality. Completion pancreatectomy is the sole curative therapy which must be initiated as quickly as possible.</description><subject>Adolescent</subject><subject>Adult</subject><subject>Aged</subject><subject>Aged, 80 and over</subject><subject>Anastomosis, Surgical - adverse effects</subject><subject>Anastomosis, Surgical - methods</subject><subject>Female</subject><subject>Fistula</subject><subject>Germany - epidemiology</subject><subject>Humans</subject><subject>Incidence</subject><subject>International Study Group of Pancreatic Surgery</subject><subject>Jejunum - surgery</subject><subject>Male</subject><subject>Middle Aged</subject><subject>Mortality</subject><subject>Pancreas - surgery</subject><subject>Pancreatic Diseases - etiology</subject><subject>Pancreatic Diseases - mortality</subject><subject>Pancreatic Diseases - surgery</subject><subject>Pancreatic Ducts - surgery</subject><subject>Pancreatic Fistula - classification</subject><subject>Pancreatic Fistula - epidemiology</subject><subject>Pancreatic Fistula - mortality</subject><subject>Pancreatic Fistula - surgery</subject><subject>Pancreaticoduodenectomy</subject><subject>Pancreaticoduodenectomy - adverse effects</subject><subject>Pancreaticoduodenectomy - methods</subject><subject>postoperative pancreatic fistula</subject><subject>Reoperation</subject><subject>Retrospective Studies</subject><subject>Risk Assessment</subject><subject>Risk Factors</subject><subject>Stomach - surgery</subject><subject>Treatment Outcome</subject><subject>Whipple's procedure</subject><subject>Young Adult</subject><issn>1868-6974</issn><issn>1868-6982</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2020</creationdate><recordtype>article</recordtype><recordid>eNp1kU9u1DAUhyMEotVQiRMgSywoi5Q4zjgJuzKi00GVGGlgHb2xXzIeJXbwH1Buw1m4ChfBoaVFSHjjZ_vTZz__kuQ5zS5oluVvjof9eFFS9ig5pRWvUl5X-eP7uixOkjPnjlkcjLKaZU-TE0brJc0qfpr8vAKhdEf8AYkLtkOjXzmiVXfwA1h8SzZaKIlaIAEtyQAaOhxQe2JaMhrnzYgWvPqKZAQtLMZakFY5H3pwpLMgkawItB7tX4SRwUQrCm-GiezBoSRG_35FGCX4uJTYKq28itvxqvlko6NEw7wFPdn5ICeytiaMM7B9uH0392GnH9_PN7v1dvf6WfKkhd7h2d28SD5fvf-0uk5vPq43q8ubVBQlYynLKlnkQuZlDpIuS6hFgZRJwPhxBWeC8iJbUuAAVZZDDVzueRtBWUioo2GRnN96R2u-BHS-GZQT2Peg0QTX5KygnLIyxrBIXv6DHk2IvfUzVdWU1nnFH4TCGucsts1oVYxlamjWzNk3c_ZNzD6iL-6EYT-gvAf_JB2B9Bb4pnqc_itqPly_287CXxSsvUA</recordid><startdate>202004</startdate><enddate>202004</enddate><creator>Luu, Andreas Minh</creator><creator>Krasemann, Lukas</creator><creator>Fahlbusch, Tim</creator><creator>Belyaev, Orlin</creator><creator>Janot‐Matuschek, Monika</creator><creator>Uhl, Waldemar</creator><creator>Braumann, Chris</creator><general>Wiley Subscription Services, Inc</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>K9.</scope><scope>7X8</scope><orcidid>https://orcid.org/0000-0001-8981-8973</orcidid></search><sort><creationdate>202004</creationdate><title>Facing the surgeon's nightmare: Incidence and management of postoperative pancreatic fistulas grade C after pancreaticoduodenectomy based on the updated definition of the International Study Group of Pancreatic Surgery (ISGPS)</title><author>Luu, Andreas Minh ; Krasemann, Lukas ; Fahlbusch, Tim ; Belyaev, Orlin ; Janot‐Matuschek, Monika ; Uhl, Waldemar ; Braumann, Chris</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c4733-308d42cd272ad157a9c4e13dae031463c164051a6aa802a9a6db6f157d4da9733</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2020</creationdate><topic>Adolescent</topic><topic>Adult</topic><topic>Aged</topic><topic>Aged, 80 and over</topic><topic>Anastomosis, Surgical - adverse effects</topic><topic>Anastomosis, Surgical - methods</topic><topic>Female</topic><topic>Fistula</topic><topic>Germany - epidemiology</topic><topic>Humans</topic><topic>Incidence</topic><topic>International Study Group of Pancreatic Surgery</topic><topic>Jejunum - surgery</topic><topic>Male</topic><topic>Middle Aged</topic><topic>Mortality</topic><topic>Pancreas - surgery</topic><topic>Pancreatic Diseases - etiology</topic><topic>Pancreatic Diseases - mortality</topic><topic>Pancreatic Diseases - surgery</topic><topic>Pancreatic Ducts - surgery</topic><topic>Pancreatic Fistula - classification</topic><topic>Pancreatic Fistula - epidemiology</topic><topic>Pancreatic Fistula - mortality</topic><topic>Pancreatic Fistula - surgery</topic><topic>Pancreaticoduodenectomy</topic><topic>Pancreaticoduodenectomy - adverse effects</topic><topic>Pancreaticoduodenectomy - methods</topic><topic>postoperative pancreatic fistula</topic><topic>Reoperation</topic><topic>Retrospective Studies</topic><topic>Risk Assessment</topic><topic>Risk Factors</topic><topic>Stomach - surgery</topic><topic>Treatment Outcome</topic><topic>Whipple's procedure</topic><topic>Young Adult</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Luu, Andreas Minh</creatorcontrib><creatorcontrib>Krasemann, Lukas</creatorcontrib><creatorcontrib>Fahlbusch, Tim</creatorcontrib><creatorcontrib>Belyaev, Orlin</creatorcontrib><creatorcontrib>Janot‐Matuschek, Monika</creatorcontrib><creatorcontrib>Uhl, Waldemar</creatorcontrib><creatorcontrib>Braumann, Chris</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>MEDLINE - Academic</collection><jtitle>Journal of hepato-biliary-pancreatic sciences</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Luu, Andreas Minh</au><au>Krasemann, Lukas</au><au>Fahlbusch, Tim</au><au>Belyaev, Orlin</au><au>Janot‐Matuschek, Monika</au><au>Uhl, Waldemar</au><au>Braumann, Chris</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Facing the surgeon's nightmare: Incidence and management of postoperative pancreatic fistulas grade C after pancreaticoduodenectomy based on the updated definition of the International Study Group of Pancreatic Surgery (ISGPS)</atitle><jtitle>Journal of hepato-biliary-pancreatic sciences</jtitle><addtitle>J Hepatobiliary Pancreat Sci</addtitle><date>2020-04</date><risdate>2020</risdate><volume>27</volume><issue>4</issue><spage>171</spage><epage>181</epage><pages>171-181</pages><issn>1868-6974</issn><eissn>1868-6982</eissn><abstract>Background
Postoperative pancreatic fistulas (POPF) grade C represent a rare but feared complication following pancreaticoduodenectomy (PD). They can contribute significantly to postoperative morbidity and mortality.
Methods
We performed a retrospective chart review for all patients who had undergone pancreatic head resection between 2007 and 2016 to identify those who suffered from POPF grade C according to the updated definition of the International Study Group of Pancreatic Surgery (ISGPS).
Results
A total of 722 patients underwent PD. Twenty‐three patients (3.19%) developed a POPF grade C. Cardiovascular diseases, soft pancreatic texture and main pancreatic duct diameter were identified as risk factors (P < .05). Reoperation was necessary in all affected patients on postoperative day 12 ± 9 on average. Mortality was significantly associated with POPF grade C (P < .05) being present in 39.1% (9/23).
Conclusions
POPF grade C after PD remains a serious complication with a high level of morbidity and mortality. Surgical treatment is the sole curative therapy and thus the treatment of choice.
Highlight
Postoperative pancreatic fistulas grade C are a rare complication contributing significantly to postoperative morbidity and mortality. Completion pancreatectomy is the sole curative therapy which must be initiated as quickly as possible.</abstract><cop>Japan</cop><pub>Wiley Subscription Services, Inc</pub><pmid>31951086</pmid><doi>10.1002/jhbp.713</doi><tpages>11</tpages><orcidid>https://orcid.org/0000-0001-8981-8973</orcidid><oa>free_for_read</oa></addata></record> |
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| identifier | ISSN: 1868-6974 |
| ispartof | Journal of hepato-biliary-pancreatic sciences, 2020-04, Vol.27 (4), p.171-181 |
| issn | 1868-6974 1868-6982 |
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| source | Wiley-Blackwell Read & Publish Collection |
| subjects | Adolescent Adult Aged Aged, 80 and over Anastomosis, Surgical - adverse effects Anastomosis, Surgical - methods Female Fistula Germany - epidemiology Humans Incidence International Study Group of Pancreatic Surgery Jejunum - surgery Male Middle Aged Mortality Pancreas - surgery Pancreatic Diseases - etiology Pancreatic Diseases - mortality Pancreatic Diseases - surgery Pancreatic Ducts - surgery Pancreatic Fistula - classification Pancreatic Fistula - epidemiology Pancreatic Fistula - mortality Pancreatic Fistula - surgery Pancreaticoduodenectomy Pancreaticoduodenectomy - adverse effects Pancreaticoduodenectomy - methods postoperative pancreatic fistula Reoperation Retrospective Studies Risk Assessment Risk Factors Stomach - surgery Treatment Outcome Whipple's procedure Young Adult |
| title | Facing the surgeon's nightmare: Incidence and management of postoperative pancreatic fistulas grade C after pancreaticoduodenectomy based on the updated definition of the International Study Group of Pancreatic Surgery (ISGPS) |
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