Analysis of risk factors for postoperative pancreatic fistula following pancreaticoduodenectomy

Abstract

A pancreatic duct diameter ≤ 3 mm is an independent risk factor for POPF. External stent drainage of pancreatic secretion may reduce CR-POPF mortality and POPF severity.

Predict pancreatic fistula after pancreaticoduodenectomy: ratio body thickness/main duct

“…The incidence of all POPF can vary greatly, from 4% in specific subgroups to more than 30%, according to the indication for pancreatoduodenectomy: POPF rate used to be lower in cases of chronic pancreatitis or ductal adenocarcinoma, compared with ampulloma and endocrine tumours . In our series, POPF occurred in 25% of patients, and particularly in cases of endocrine tumours (23.9 versus 6.4% of endocrine tumours without POPF, P < 0.01), which is in accordance with the literature.…”

“…The size of the main pancreatic duct, assessed either preoperatively on imaging or intraoperatively by the surgeon, has been identified as predictive factor of POPF, by many authors . The most widely used cut‐off value for the occurrence of POPF was 3 mm . Location of pancreatic duct in the stump has been also studied, with conflicting results: Yamamoto et al .…”

Duct-to-mucosa pancreaticojejunostomy can reduce the risk of pancreatic fistula after pancreaticoduodenectomy

“…Systemic factors, such as elderly age (>65 years), epigastrium surgery, preoperative nutritional status, preoperative jaundice, preoperative hemoglobin, hypertension, diabetes and other associated underlying diseases. However, Liu Qiuyu et al found that age, gender, body mass index, hypertension, diabetes mellitus, history of jaundice, serum albumin level, and blood loss volume have no statistical difference related to the morbidity of POPF after multivariate analysis [4] . 2.…”

Prevention of pancreatic fistula using polyethylene glycolic acid mesh reinforcement around pancreatojejunostomy: the propensity score-matched analysis

“…Studies have reported that risk factors for POPF included a higher BMI, soft pancreatic texture and a smaller pancreatic duct size . Several fistula risk scoring systems have been published , with one tested for its ability to predict POPF in a multicenter cohort .…”

“…Thus, even after controlling for confounding factors and bias, which are limitations of nonrandomized retrospective studies, PGA mesh could prevent clinically relevant POPF and its complications. Studies have reported that risk factors for POPF included a higher BMI, soft pancreatic texture and a smaller pancreatic duct size [31][32][33][34]. Several fistula risk scoring systems have been published [17,35], with one tested for its ability to predict POPF in a multicenter cohort [36].…”