Risk Factors and Medico-Economic Effect of Pancreatic Fistula after Pancreaticoduodenectomy

Abstract

The study aimed to uncover the risk factors for the new defined pancreatic fistula (PF) and clinical related PF (CR-PF) after pancreaticoduodenectomy (PD) surgery and to evaluate the medico-economic effect of patients. A total of 412 patients were classified into two groups according to different criteria, PF and NOPF according to PF occurrence: CR-PF (grades B and C) and NOCR-PF (grade A) based on PF severity. A total of 28 factors were evaluated by univariate and multivariate logistic regression test. Hospital charges and stays of these patients were assessed. The results showed that more hospital stages and charges are needed for patients in PF and CR-PF groups than in NOPF and NOCR-PF groups (P < 0.05). The excessive drinking, soft remnant pancreas, preoperative albumin, and intraoperative blood transfusion are risk factors affecting both PF and CR-PF incidence. More professional surgeons can effectively reduce the PF and CR-PF incidence. Patients with PF and CR-PF need more hospital costs and stages than that in NOPF and NOCR-PF groups. It is critical that surgeons know the risk factors related to PF and CR-PF so as to take corresponding therapeutic regimens for each patient.

Systematic review and meta‐analysis of factors associated with post‐operative pancreatic fistula following pancreatoduodenectomy

“…Some 23 665 patients had malignant disease and of these 12 097 had pancreatic ductal adenocarcinoma, 3778 distal cholangiocarcinoma, 3189 ampullary carcinoma and 1456 duodenal carcinoma. Study characteristics are summarized in Table S3 14–126 . Ninety‐one studies were retrospective cohort studies, 28 prospective cohort studies and three randomized controlled trials.…”

Perioperative albumin ratio is associated with post‐operative pancreatic fistula

“…1 Identification of patients at high risk of POPF remains a big challenge in order to define an accurate post-operative management and reduce risk of potentially lethal complications. 1 Identification of patients at high risk of POPF remains a big challenge in order to define an accurate post-operative management and reduce risk of potentially lethal complications.…”

“…POPF represents the most frequent complication after PD and is still high and commonly associated with prolonged hospital stay and increased cost. 1 Identification of patients at high risk of POPF remains a big challenge in order to define an accurate post-operative management and reduce risk of potentially lethal complications.…”

“…1 Post-operative pancreatic fistula (POPF) represents the most frequent complication after PD and could lead to life-threatening conditions such as bleeding, abscess and sepsis in 9-14% of patients even at high volume centres, with in-hospital death rates of 0-4%. 1 Post-operative pancreatic fistula (POPF) represents the most frequent complication after PD and could lead to life-threatening conditions such as bleeding, abscess and sepsis in 9-14% of patients even at high volume centres, with in-hospital death rates of 0-4%.…”

“…Despite recent advances in surgical procedures and post-operative management techniques, morbidity and mortality after pancreaticoduodenectomy (PD) are still high and commonly associated with prolonged hospital stay and increased cost. 1 Post-operative pancreatic fistula (POPF) represents the most frequent complication after PD and could lead to life-threatening conditions such as bleeding, abscess and sepsis in 9-14% of patients even at high volume centres, with in-hospital death rates of 0-4%. [1][2][3][4][5][6] Identification of patients at high risk of POPF remains a big challenge in order to define an accurate post-operative management and reduce risk of potentially lethal complications.…”