Postoperative infectious complications after pancreatic resection

Okano, Keiichi; Hirao, Tomohiro; Unno, Michiaki; Fujii, Tsutomu; Yoshitomi, Hideyuki; Suzuki, Shuji; Satoi, Sohei; Takahashi, Shinichiro; Kainuma, Osamu; Suzuki, Yasuyuki

doi:10.1002/bjs.9919

Cited by 102 publications

(104 citation statements)

References 43 publications

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“…As a result, the postoperative mortality and morbidity rates after PD remain high (2.8–3.5% and 40%, respectively) according to nationwide surveys performed in Japan [1, 2]. Furthermore, infectious complications after pancreatic surgery are common during the postoperative course, and can lead to fatal outcomes [3]. High morbidity rates are associated with the need for further treatment and extended hospital stays.…”

Section: Introductionmentioning

confidence: 99%

Radiographic sarcopenia predicts postoperative infectious complications in patients undergoing pancreaticoduodenectomy

et al. 2017

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BackgroundRecently, skeletal muscle depletion (sarcopenia) has been reported to influence postoperative outcomes after certain procedures. This study investigated the impact of sarcopenia on postoperative outcomes following pancreaticoduodenectomy (PD).MethodsWe performed a retrospective study of consecutive patients (n = 219) who underwent PD at our institution between January 2007 and May 2013. Sarcopenia was evaluated using preoperative computed tomography. We evaluated postoperative outcomes and the influence of sarcopenia on short-term outcomes, especially infectious complications. Subsequently, multivariate analysis was used to assess the impact of prognostic factors (including sarcopenia) on postoperative infections.ResultsThe mortality, major complication, and infectious complication rates for all patients were 1.4%, 16.4%, and 47.0%, respectively. Fifty-five patients met the criteria for sarcopenia. Sarcopenia was significantly associated with a higher incidence of in-hospital mortality (P = 0.004) and infectious complications (P < 0.001). In multivariate analyses, sarcopenia (odds ratio = 3.43; P < 0.001), preoperative biliary drainage (odds ratio = 2.20; P = 0.014), blood loss (odds ratio = 1.92; P = 0.048), and soft pancreatic texture (odds ratio = 3.71; P < 0.001) were independent predictors of postoperative infections.ConclusionsSarcopenia is an independent preoperative predictor of infectious complications after PD. Clinical assessment combined with sarcopenia may be helpful for understanding the risk of postoperative outcomes and determining perioperative management strategies.

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Section: Introductionmentioning

confidence: 99%

Radiographic sarcopenia predicts postoperative infectious complications in patients undergoing pancreaticoduodenectomy

et al. 2017

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“…Pancreatic resections remain high‐risk procedures, even in well‐selected patients . Serious postoperative complications, including postoperative mortality and severe morbidity, are commonplace and require extensive perioperative management and resources .…”

Section: Introductionmentioning

confidence: 99%

Gender as a risk factor for adverse intraoperative and postoperative outcomes of elective pancreatectomy

Mazmudar

Vitello

Chapman

et al. 2016

Journal of Surgical Oncology

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“…In a recent study by Okano et al (17), both variables were independently associated with infectious complications. Previous studies showed male gender to be related to specific complications, such as surgical site infection, pancreatic fistula and delayed gastric emptying (17)(18)(19). Recent studies have shown visceral fat as a predictor for pancreatic fistula and postoperative mortality (20,21).…”

Section: Discussionmentioning

confidence: 87%

Advanced age does not increase morbidity in pancreaticoduodenectomy

Namur¹,

Dantas²,

Jureidini³

et al. 2018

J. Gastrointest. Oncol.

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Background: Due to rising life expectancy of population, very complex surgical procedures such as pancreaticoduodenectomy (PD), are more commonly being performed in elderly patients. The objective of this study was to evaluate the safety of PD in patients older than 75 years old and the risk factors associated with severe complications.Methods: Patients who underwent PD for periampullary tumors were retrospectively reviewed and divided into two groups, A (<75 years) and B (>75 years). The primary endpoint was severe postoperative complications (Clavien 3 or greater). Secondary endpoints were mortality and any complications.Results: Ninety consecutive patients underwent PD for periampullary tumors in the studied period, 70 in group A and 20 in group B. Clinical and pathological characteristics of both groups were equivalents except for age. There were no difference regarding the incidence of severe complications (17% vs. 10%, P=0.72) or all complications (50% vs. 50%, P>0.999). Although mortality was greater in group A (8.6% vs. 0%), it was not statistically significant (P=0.333). On multivariate analyses, only male sex, obesity and American Society of Anesthesiology Score of 3 or 4 were associated with severe postoperative complications. Conclusions:Poor clinical status, obesity and male gender are associated with severe complications in PD, but not age greater than 75 years, therefore PD can be considered safe in elderly patients and age itself should not be a contraindication for PD.

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Postoperative infectious complications after pancreatic resection

Abstract: Prolonged operating time, intraoperative blood transfusion, bile contamination (PD) and non-laparoscopic surgery (DP) are risk factors for postoperative infectious complications that could be targeted to improve outcome after pancreatectomy.

Cited by 102 publications

References 43 publications

Radiographic sarcopenia predicts postoperative infectious complications in patients undergoing pancreaticoduodenectomy

Radiographic sarcopenia predicts postoperative infectious complications in patients undergoing pancreaticoduodenectomy

Gender as a risk factor for adverse intraoperative and postoperative outcomes of elective pancreatectomy

Advanced age does not increase morbidity in pancreaticoduodenectomy

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