Predictors and Outcomes of Pancreatic Fistula Following Pancreaticoduodenectomy: a Dual Center Experience
Abstract Fistula following leaked pancreatico-enteric anastomosis is a common, potentially lethal complication of pancreaticoduodenectomy (PD). Early assessment and prediction of its occurrence can improve postoperative outcomes. Various perioperative factors were analyzed for its contribution to cl...
Ausführliche Beschreibung
Gespeichert in:
| Autor*in: |
Kumar, Suneed [verfasserIn] Chandra, Abhijit [verfasserIn] Madhavan, Shibumon M. [verfasserIn] Kumar, Dinesh [verfasserIn] Chauhan, Smita [verfasserIn] Pandey, Anshuman [verfasserIn] Masood, Shakeel [verfasserIn] |
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| Format: |
E-Artikel |
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| Sprache: |
Englisch |
| Erschienen: |
2020 |
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| Schlagwörter: |
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| Übergeordnetes Werk: |
Enthalten in: Indian Journal of Surgical Oncology - Springer-Verlag, 2010, 12(2020), 1 vom: 27. Aug., Seite 22-30 |
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| Übergeordnetes Werk: |
volume:12 ; year:2020 ; number:1 ; day:27 ; month:08 ; pages:22-30 |
| Links: |
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| DOI / URN: |
10.1007/s13193-020-01195-3 |
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| Katalog-ID: |
SPR043508898 |
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| 520 | |a Abstract Fistula following leaked pancreatico-enteric anastomosis is a common, potentially lethal complication of pancreaticoduodenectomy (PD). Early assessment and prediction of its occurrence can improve postoperative outcomes. Various perioperative factors were analyzed for its contribution to clinically relevant postoperative pancreatic fistula (crPOPF). Also, the difference in clinical outcomes of patients with and without fistula was studied. Sixty-seven patients undergoing PD for malignancies were analyzed during 3-year period in a dual-institutional study. Various preoperative, intraoperative, and postoperative factors were assessed. The incidence and severity of POPF and its association with the development of other post-PD complications were observed. Patients with and without POPF were divided into groups and compared with univariate and multivariate analyses, to identify significant contributing factors. Clinically relevant POPF was present in 20.9% cases. crPOPF contributed to delayed gastric emptying, albeit insignificant (p = 0.403), but was significantly associated with increased incidence of post-pancreatectomy hemorrhagic (p = 0.005) and infectious complications (p = 0.013). Soft pancreas (p = 0.024), intraoperative blood loss (p = 0.045), blood transfusion (p = 0.024), and fistula risk score (p = 0.001) were significant predictors of crPOPF. First postoperative day (POD1) drain fluid amylase (DFA) values at cut-off of 1336 U/L (AUC = 0.871; p < 0.001) significantly predicted crPOPF with good sensitivity and specificity. POD1 DFA was only factor significant on multivariate analysis (p = 0.014). There was no significant difference in overall survival between groups. crPOPF results in significant post-pancreatectomy hemorrhagic and septic complications, along with increased mortality. It can be accurately predicted by several preoperative and intraoperative factors. POD1 DFA can independently predict crPOPF development. | ||
| 650 | 4 | |a Whipple’s procedure |7 (dpeaa)DE-He213 | |
| 650 | 4 | |a Complications |7 (dpeaa)DE-He213 | |
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| 700 | 1 | |a Pandey, Anshuman |e verfasserin |4 aut | |
| 700 | 1 | |a Masood, Shakeel |e verfasserin |4 aut | |
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10.1007/s13193-020-01195-3 doi (DE-627)SPR043508898 (DE-599)SPRs13193-020-01195-3-e (SPR)s13193-020-01195-3-e DE-627 ger DE-627 rakwb eng Kumar, Suneed verfasserin aut Predictors and Outcomes of Pancreatic Fistula Following Pancreaticoduodenectomy: a Dual Center Experience 2020 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier Abstract Fistula following leaked pancreatico-enteric anastomosis is a common, potentially lethal complication of pancreaticoduodenectomy (PD). Early assessment and prediction of its occurrence can improve postoperative outcomes. Various perioperative factors were analyzed for its contribution to clinically relevant postoperative pancreatic fistula (crPOPF). Also, the difference in clinical outcomes of patients with and without fistula was studied. Sixty-seven patients undergoing PD for malignancies were analyzed during 3-year period in a dual-institutional study. Various preoperative, intraoperative, and postoperative factors were assessed. The incidence and severity of POPF and its association with the development of other post-PD complications were observed. Patients with and without POPF were divided into groups and compared with univariate and multivariate analyses, to identify significant contributing factors. Clinically relevant POPF was present in 20.9% cases. crPOPF contributed to delayed gastric emptying, albeit insignificant (p = 0.403), but was significantly associated with increased incidence of post-pancreatectomy hemorrhagic (p = 0.005) and infectious complications (p = 0.013). Soft pancreas (p = 0.024), intraoperative blood loss (p = 0.045), blood transfusion (p = 0.024), and fistula risk score (p = 0.001) were significant predictors of crPOPF. First postoperative day (POD1) drain fluid amylase (DFA) values at cut-off of 1336 U/L (AUC = 0.871; p < 0.001) significantly predicted crPOPF with good sensitivity and specificity. POD1 DFA was only factor significant on multivariate analysis (p = 0.014). There was no significant difference in overall survival between groups. crPOPF results in significant post-pancreatectomy hemorrhagic and septic complications, along with increased mortality. It can be accurately predicted by several preoperative and intraoperative factors. POD1 DFA can independently predict crPOPF development. Whipple’s procedure (dpeaa)DE-He213 Complications (dpeaa)DE-He213 Clinically relevant POPF (dpeaa)DE-He213 Periampullary cancer (dpeaa)DE-He213 Chandra, Abhijit verfasserin aut Madhavan, Shibumon M. verfasserin aut Kumar, Dinesh verfasserin aut Chauhan, Smita verfasserin aut Pandey, Anshuman verfasserin aut Masood, Shakeel verfasserin aut Enthalten in Indian Journal of Surgical Oncology Springer-Verlag, 2010 12(2020), 1 vom: 27. Aug., Seite 22-30 (DE-627)SPR030797241 nnns volume:12 year:2020 number:1 day:27 month:08 pages:22-30 https://dx.doi.org/10.1007/s13193-020-01195-3 lizenzpflichtig Volltext GBV_USEFLAG_A SYSFLAG_A GBV_SPRINGER SSG-OLC-PHA AR 12 2020 1 27 08 22-30 |
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10.1007/s13193-020-01195-3 doi (DE-627)SPR043508898 (DE-599)SPRs13193-020-01195-3-e (SPR)s13193-020-01195-3-e DE-627 ger DE-627 rakwb eng Kumar, Suneed verfasserin aut Predictors and Outcomes of Pancreatic Fistula Following Pancreaticoduodenectomy: a Dual Center Experience 2020 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier Abstract Fistula following leaked pancreatico-enteric anastomosis is a common, potentially lethal complication of pancreaticoduodenectomy (PD). Early assessment and prediction of its occurrence can improve postoperative outcomes. Various perioperative factors were analyzed for its contribution to clinically relevant postoperative pancreatic fistula (crPOPF). Also, the difference in clinical outcomes of patients with and without fistula was studied. Sixty-seven patients undergoing PD for malignancies were analyzed during 3-year period in a dual-institutional study. Various preoperative, intraoperative, and postoperative factors were assessed. The incidence and severity of POPF and its association with the development of other post-PD complications were observed. Patients with and without POPF were divided into groups and compared with univariate and multivariate analyses, to identify significant contributing factors. Clinically relevant POPF was present in 20.9% cases. crPOPF contributed to delayed gastric emptying, albeit insignificant (p = 0.403), but was significantly associated with increased incidence of post-pancreatectomy hemorrhagic (p = 0.005) and infectious complications (p = 0.013). Soft pancreas (p = 0.024), intraoperative blood loss (p = 0.045), blood transfusion (p = 0.024), and fistula risk score (p = 0.001) were significant predictors of crPOPF. First postoperative day (POD1) drain fluid amylase (DFA) values at cut-off of 1336 U/L (AUC = 0.871; p < 0.001) significantly predicted crPOPF with good sensitivity and specificity. POD1 DFA was only factor significant on multivariate analysis (p = 0.014). There was no significant difference in overall survival between groups. crPOPF results in significant post-pancreatectomy hemorrhagic and septic complications, along with increased mortality. It can be accurately predicted by several preoperative and intraoperative factors. POD1 DFA can independently predict crPOPF development. Whipple’s procedure (dpeaa)DE-He213 Complications (dpeaa)DE-He213 Clinically relevant POPF (dpeaa)DE-He213 Periampullary cancer (dpeaa)DE-He213 Chandra, Abhijit verfasserin aut Madhavan, Shibumon M. verfasserin aut Kumar, Dinesh verfasserin aut Chauhan, Smita verfasserin aut Pandey, Anshuman verfasserin aut Masood, Shakeel verfasserin aut Enthalten in Indian Journal of Surgical Oncology Springer-Verlag, 2010 12(2020), 1 vom: 27. Aug., Seite 22-30 (DE-627)SPR030797241 nnns volume:12 year:2020 number:1 day:27 month:08 pages:22-30 https://dx.doi.org/10.1007/s13193-020-01195-3 lizenzpflichtig Volltext GBV_USEFLAG_A SYSFLAG_A GBV_SPRINGER SSG-OLC-PHA AR 12 2020 1 27 08 22-30 |
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10.1007/s13193-020-01195-3 doi (DE-627)SPR043508898 (DE-599)SPRs13193-020-01195-3-e (SPR)s13193-020-01195-3-e DE-627 ger DE-627 rakwb eng Kumar, Suneed verfasserin aut Predictors and Outcomes of Pancreatic Fistula Following Pancreaticoduodenectomy: a Dual Center Experience 2020 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier Abstract Fistula following leaked pancreatico-enteric anastomosis is a common, potentially lethal complication of pancreaticoduodenectomy (PD). Early assessment and prediction of its occurrence can improve postoperative outcomes. Various perioperative factors were analyzed for its contribution to clinically relevant postoperative pancreatic fistula (crPOPF). Also, the difference in clinical outcomes of patients with and without fistula was studied. Sixty-seven patients undergoing PD for malignancies were analyzed during 3-year period in a dual-institutional study. Various preoperative, intraoperative, and postoperative factors were assessed. The incidence and severity of POPF and its association with the development of other post-PD complications were observed. Patients with and without POPF were divided into groups and compared with univariate and multivariate analyses, to identify significant contributing factors. Clinically relevant POPF was present in 20.9% cases. crPOPF contributed to delayed gastric emptying, albeit insignificant (p = 0.403), but was significantly associated with increased incidence of post-pancreatectomy hemorrhagic (p = 0.005) and infectious complications (p = 0.013). Soft pancreas (p = 0.024), intraoperative blood loss (p = 0.045), blood transfusion (p = 0.024), and fistula risk score (p = 0.001) were significant predictors of crPOPF. First postoperative day (POD1) drain fluid amylase (DFA) values at cut-off of 1336 U/L (AUC = 0.871; p < 0.001) significantly predicted crPOPF with good sensitivity and specificity. POD1 DFA was only factor significant on multivariate analysis (p = 0.014). There was no significant difference in overall survival between groups. crPOPF results in significant post-pancreatectomy hemorrhagic and septic complications, along with increased mortality. It can be accurately predicted by several preoperative and intraoperative factors. POD1 DFA can independently predict crPOPF development. Whipple’s procedure (dpeaa)DE-He213 Complications (dpeaa)DE-He213 Clinically relevant POPF (dpeaa)DE-He213 Periampullary cancer (dpeaa)DE-He213 Chandra, Abhijit verfasserin aut Madhavan, Shibumon M. verfasserin aut Kumar, Dinesh verfasserin aut Chauhan, Smita verfasserin aut Pandey, Anshuman verfasserin aut Masood, Shakeel verfasserin aut Enthalten in Indian Journal of Surgical Oncology Springer-Verlag, 2010 12(2020), 1 vom: 27. Aug., Seite 22-30 (DE-627)SPR030797241 nnns volume:12 year:2020 number:1 day:27 month:08 pages:22-30 https://dx.doi.org/10.1007/s13193-020-01195-3 lizenzpflichtig Volltext GBV_USEFLAG_A SYSFLAG_A GBV_SPRINGER SSG-OLC-PHA AR 12 2020 1 27 08 22-30 |
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10.1007/s13193-020-01195-3 doi (DE-627)SPR043508898 (DE-599)SPRs13193-020-01195-3-e (SPR)s13193-020-01195-3-e DE-627 ger DE-627 rakwb eng Kumar, Suneed verfasserin aut Predictors and Outcomes of Pancreatic Fistula Following Pancreaticoduodenectomy: a Dual Center Experience 2020 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier Abstract Fistula following leaked pancreatico-enteric anastomosis is a common, potentially lethal complication of pancreaticoduodenectomy (PD). Early assessment and prediction of its occurrence can improve postoperative outcomes. Various perioperative factors were analyzed for its contribution to clinically relevant postoperative pancreatic fistula (crPOPF). Also, the difference in clinical outcomes of patients with and without fistula was studied. Sixty-seven patients undergoing PD for malignancies were analyzed during 3-year period in a dual-institutional study. Various preoperative, intraoperative, and postoperative factors were assessed. The incidence and severity of POPF and its association with the development of other post-PD complications were observed. Patients with and without POPF were divided into groups and compared with univariate and multivariate analyses, to identify significant contributing factors. Clinically relevant POPF was present in 20.9% cases. crPOPF contributed to delayed gastric emptying, albeit insignificant (p = 0.403), but was significantly associated with increased incidence of post-pancreatectomy hemorrhagic (p = 0.005) and infectious complications (p = 0.013). Soft pancreas (p = 0.024), intraoperative blood loss (p = 0.045), blood transfusion (p = 0.024), and fistula risk score (p = 0.001) were significant predictors of crPOPF. First postoperative day (POD1) drain fluid amylase (DFA) values at cut-off of 1336 U/L (AUC = 0.871; p < 0.001) significantly predicted crPOPF with good sensitivity and specificity. POD1 DFA was only factor significant on multivariate analysis (p = 0.014). There was no significant difference in overall survival between groups. crPOPF results in significant post-pancreatectomy hemorrhagic and septic complications, along with increased mortality. It can be accurately predicted by several preoperative and intraoperative factors. POD1 DFA can independently predict crPOPF development. Whipple’s procedure (dpeaa)DE-He213 Complications (dpeaa)DE-He213 Clinically relevant POPF (dpeaa)DE-He213 Periampullary cancer (dpeaa)DE-He213 Chandra, Abhijit verfasserin aut Madhavan, Shibumon M. verfasserin aut Kumar, Dinesh verfasserin aut Chauhan, Smita verfasserin aut Pandey, Anshuman verfasserin aut Masood, Shakeel verfasserin aut Enthalten in Indian Journal of Surgical Oncology Springer-Verlag, 2010 12(2020), 1 vom: 27. Aug., Seite 22-30 (DE-627)SPR030797241 nnns volume:12 year:2020 number:1 day:27 month:08 pages:22-30 https://dx.doi.org/10.1007/s13193-020-01195-3 lizenzpflichtig Volltext GBV_USEFLAG_A SYSFLAG_A GBV_SPRINGER SSG-OLC-PHA AR 12 2020 1 27 08 22-30 |
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10.1007/s13193-020-01195-3 doi (DE-627)SPR043508898 (DE-599)SPRs13193-020-01195-3-e (SPR)s13193-020-01195-3-e DE-627 ger DE-627 rakwb eng Kumar, Suneed verfasserin aut Predictors and Outcomes of Pancreatic Fistula Following Pancreaticoduodenectomy: a Dual Center Experience 2020 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier Abstract Fistula following leaked pancreatico-enteric anastomosis is a common, potentially lethal complication of pancreaticoduodenectomy (PD). Early assessment and prediction of its occurrence can improve postoperative outcomes. Various perioperative factors were analyzed for its contribution to clinically relevant postoperative pancreatic fistula (crPOPF). Also, the difference in clinical outcomes of patients with and without fistula was studied. Sixty-seven patients undergoing PD for malignancies were analyzed during 3-year period in a dual-institutional study. Various preoperative, intraoperative, and postoperative factors were assessed. The incidence and severity of POPF and its association with the development of other post-PD complications were observed. Patients with and without POPF were divided into groups and compared with univariate and multivariate analyses, to identify significant contributing factors. Clinically relevant POPF was present in 20.9% cases. crPOPF contributed to delayed gastric emptying, albeit insignificant (p = 0.403), but was significantly associated with increased incidence of post-pancreatectomy hemorrhagic (p = 0.005) and infectious complications (p = 0.013). Soft pancreas (p = 0.024), intraoperative blood loss (p = 0.045), blood transfusion (p = 0.024), and fistula risk score (p = 0.001) were significant predictors of crPOPF. First postoperative day (POD1) drain fluid amylase (DFA) values at cut-off of 1336 U/L (AUC = 0.871; p < 0.001) significantly predicted crPOPF with good sensitivity and specificity. POD1 DFA was only factor significant on multivariate analysis (p = 0.014). There was no significant difference in overall survival between groups. crPOPF results in significant post-pancreatectomy hemorrhagic and septic complications, along with increased mortality. It can be accurately predicted by several preoperative and intraoperative factors. POD1 DFA can independently predict crPOPF development. Whipple’s procedure (dpeaa)DE-He213 Complications (dpeaa)DE-He213 Clinically relevant POPF (dpeaa)DE-He213 Periampullary cancer (dpeaa)DE-He213 Chandra, Abhijit verfasserin aut Madhavan, Shibumon M. verfasserin aut Kumar, Dinesh verfasserin aut Chauhan, Smita verfasserin aut Pandey, Anshuman verfasserin aut Masood, Shakeel verfasserin aut Enthalten in Indian Journal of Surgical Oncology Springer-Verlag, 2010 12(2020), 1 vom: 27. Aug., Seite 22-30 (DE-627)SPR030797241 nnns volume:12 year:2020 number:1 day:27 month:08 pages:22-30 https://dx.doi.org/10.1007/s13193-020-01195-3 lizenzpflichtig Volltext GBV_USEFLAG_A SYSFLAG_A GBV_SPRINGER SSG-OLC-PHA AR 12 2020 1 27 08 22-30 |
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Enthalten in Indian Journal of Surgical Oncology 12(2020), 1 vom: 27. Aug., Seite 22-30 volume:12 year:2020 number:1 day:27 month:08 pages:22-30 |
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predictors and outcomes of pancreatic fistula following pancreaticoduodenectomy: a dual center experience |
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Predictors and Outcomes of Pancreatic Fistula Following Pancreaticoduodenectomy: a Dual Center Experience |
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Abstract Fistula following leaked pancreatico-enteric anastomosis is a common, potentially lethal complication of pancreaticoduodenectomy (PD). Early assessment and prediction of its occurrence can improve postoperative outcomes. Various perioperative factors were analyzed for its contribution to clinically relevant postoperative pancreatic fistula (crPOPF). Also, the difference in clinical outcomes of patients with and without fistula was studied. Sixty-seven patients undergoing PD for malignancies were analyzed during 3-year period in a dual-institutional study. Various preoperative, intraoperative, and postoperative factors were assessed. The incidence and severity of POPF and its association with the development of other post-PD complications were observed. Patients with and without POPF were divided into groups and compared with univariate and multivariate analyses, to identify significant contributing factors. Clinically relevant POPF was present in 20.9% cases. crPOPF contributed to delayed gastric emptying, albeit insignificant (p = 0.403), but was significantly associated with increased incidence of post-pancreatectomy hemorrhagic (p = 0.005) and infectious complications (p = 0.013). Soft pancreas (p = 0.024), intraoperative blood loss (p = 0.045), blood transfusion (p = 0.024), and fistula risk score (p = 0.001) were significant predictors of crPOPF. First postoperative day (POD1) drain fluid amylase (DFA) values at cut-off of 1336 U/L (AUC = 0.871; p < 0.001) significantly predicted crPOPF with good sensitivity and specificity. POD1 DFA was only factor significant on multivariate analysis (p = 0.014). There was no significant difference in overall survival between groups. crPOPF results in significant post-pancreatectomy hemorrhagic and septic complications, along with increased mortality. It can be accurately predicted by several preoperative and intraoperative factors. POD1 DFA can independently predict crPOPF development. |
| abstractGer |
Abstract Fistula following leaked pancreatico-enteric anastomosis is a common, potentially lethal complication of pancreaticoduodenectomy (PD). Early assessment and prediction of its occurrence can improve postoperative outcomes. Various perioperative factors were analyzed for its contribution to clinically relevant postoperative pancreatic fistula (crPOPF). Also, the difference in clinical outcomes of patients with and without fistula was studied. Sixty-seven patients undergoing PD for malignancies were analyzed during 3-year period in a dual-institutional study. Various preoperative, intraoperative, and postoperative factors were assessed. The incidence and severity of POPF and its association with the development of other post-PD complications were observed. Patients with and without POPF were divided into groups and compared with univariate and multivariate analyses, to identify significant contributing factors. Clinically relevant POPF was present in 20.9% cases. crPOPF contributed to delayed gastric emptying, albeit insignificant (p = 0.403), but was significantly associated with increased incidence of post-pancreatectomy hemorrhagic (p = 0.005) and infectious complications (p = 0.013). Soft pancreas (p = 0.024), intraoperative blood loss (p = 0.045), blood transfusion (p = 0.024), and fistula risk score (p = 0.001) were significant predictors of crPOPF. First postoperative day (POD1) drain fluid amylase (DFA) values at cut-off of 1336 U/L (AUC = 0.871; p < 0.001) significantly predicted crPOPF with good sensitivity and specificity. POD1 DFA was only factor significant on multivariate analysis (p = 0.014). There was no significant difference in overall survival between groups. crPOPF results in significant post-pancreatectomy hemorrhagic and septic complications, along with increased mortality. It can be accurately predicted by several preoperative and intraoperative factors. POD1 DFA can independently predict crPOPF development. |
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Abstract Fistula following leaked pancreatico-enteric anastomosis is a common, potentially lethal complication of pancreaticoduodenectomy (PD). Early assessment and prediction of its occurrence can improve postoperative outcomes. Various perioperative factors were analyzed for its contribution to clinically relevant postoperative pancreatic fistula (crPOPF). Also, the difference in clinical outcomes of patients with and without fistula was studied. Sixty-seven patients undergoing PD for malignancies were analyzed during 3-year period in a dual-institutional study. Various preoperative, intraoperative, and postoperative factors were assessed. The incidence and severity of POPF and its association with the development of other post-PD complications were observed. Patients with and without POPF were divided into groups and compared with univariate and multivariate analyses, to identify significant contributing factors. Clinically relevant POPF was present in 20.9% cases. crPOPF contributed to delayed gastric emptying, albeit insignificant (p = 0.403), but was significantly associated with increased incidence of post-pancreatectomy hemorrhagic (p = 0.005) and infectious complications (p = 0.013). Soft pancreas (p = 0.024), intraoperative blood loss (p = 0.045), blood transfusion (p = 0.024), and fistula risk score (p = 0.001) were significant predictors of crPOPF. First postoperative day (POD1) drain fluid amylase (DFA) values at cut-off of 1336 U/L (AUC = 0.871; p < 0.001) significantly predicted crPOPF with good sensitivity and specificity. POD1 DFA was only factor significant on multivariate analysis (p = 0.014). There was no significant difference in overall survival between groups. crPOPF results in significant post-pancreatectomy hemorrhagic and septic complications, along with increased mortality. It can be accurately predicted by several preoperative and intraoperative factors. POD1 DFA can independently predict crPOPF development. |
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