Scoring System to Predict Pancreatic Fistula After Pancreaticoduodenectomy

Abstract

The predictive score performed well and could not be improved. This provides opportunities for individualizing patient consent and selection, and treatment and research applications.

Skeletal Muscle Quality is Associated with Worse Survival After Pancreatoduodenectomy for Periampullary, Nonpancreatic Cancer

“…After resection for periampullary cancer, complications may occur even more frequently than after resection for pancreatic adenocarcinoma 28,31,32. The incidence of overall and major morbidity did not differ between the patients with low and normal muscle mass.…”

“…To our surprise, we did not find an association between muscle mass and postoperative major complications or survival in the univariate analysis. It is unlikely that the influence of muscle mass on postoperative outcomes is different after resection of periampullary cancer compared with pancreatic cancer, although the incidence of complications does differ between the two groups 28,31,32. It is unclear whether the unequal distribution of patients between low muscle mass (78 %) and normal muscle mass (22 %) could be a reason for this finding.…”

“…Conventional covariates included in the univariable survival analysis next to the dichotomous variables SMI and MAI were sex, age, American Society of Anesthesiologists (ASA) grade, tumor category, lymph node metastasis, tumor size, tumor grade, and resection margin status 16,2327 The conventional covariates included in the univariate analysis for major postoperative complications next to SMI and MAI were sex, age, ASA grade, body mass index (BMI), diabetes mellitus, and tumor location 28. Characteristics with a p value lower than 0.10 in the univariate analysis were entered into multivariable models.…”

Preoperative imaging evaluation of pancreatic pathologies for the objective prediction of pancreatic fistula after pancreaticoduodenectomy

“…Risk factors for POPF after PD include advanced age [8,9], male gender [6,8,10], obesity and high body mass index [11,12], comorbid cardiovascular diseases [13,14], lack of neoadjuvant chemoradiotherapy [15][16][17] disease pathology [4,8,10,12], soft pancreatic texture [6,8,12,13,18], small pancreatic duct [8,12,18,19], absence of pancreatic parenchymal fibrosis [18,20,21], increased pancreatic fatty infiltration [20,21], large pancreatic remnant volume [22], prolonged operation time [6,10], greater intraoperative blood loss [20], failure to use optical magnification when constructing the pancreatic anastomosis [23,24], and hospital patient volume [25,26].…”

Inter-Anastomosis Drainage Tube Between the Pancreas and Jejunum: A Novel Technique for Preventing Pancreatic Fistula after Pancreaticoduodenectomy

“…Pancreatic fistula (PF) after pancreaticoduodenectomy (PD) remains an unsolved surgical problem 1,2 , encountered at an unacceptably high rate (18.7%-31.4%) 3,4 . Once a PF has occurred, patients are constrained by the risk of lethal ruptured aneurysms 5 and prolonged hospital stays requiring intensive medical support and high expenditures 6,7 .…”