Background/Aims: The aim of the present study is the analysis of risk factors of postoperative pancreatic fistula (POPF) and of clinical outcome after pancreatoduodenectomy (PD) in a retrospective multicentric review of the patient cohort. Methodology: From January 2003 to July 2013 143 patients underwent PD: 138 cases were included and 3 groups were identified according to the different types of anastomosis: Group 1 invaginating end-to-end pancreatojejunostomy, Group 2 end-to-side pancreatojejunostomy with duct-to-mucosa anastomosis, Group 3 end-to-side pancreatogastrostomy. Results: Twenty-one % of patients developed POPF, 16% in Group 1, 27% in Group 2, 12% in Group 3. Forty % grade A, 13% grade B and 47% grade C total POPE It results that POPF occurred in 16% of hard and in 40% of soft pancreatic texture; in 11.4% of dilated Wirsung versus 30.8% of non dilated (p=0.007). Overall actuarial 1 and 3 year survival after PD is 69% and 48% respectively. Perioperative mortality is 5.8% overall, 17.85% for grade C. Conclusions: No differences have been found among surgical anastomosis techniques. Soft tissues seem to increase, while dilated Wirsung seems to decrease POPF rate. The development of POPF increase morbidity but it doesn't affect overall survival, more strictly related to tumour histopathology

DE CARLIS, L., Sguinzi, R., Ferla, F., Di Sandro, S., Dorobantu, B., De Carlis, R., et al. (2014). Pancreatoduodenectomy: Risk Factors of Postoperative Pancreatic Fistula. HEPATO-GASTROENTEROLOGY, 61(132), 1124-1132 [10.5754/hge131005].

Pancreatoduodenectomy: Risk Factors of Postoperative Pancreatic Fistula

DE CARLIS, LUCIANO GREGORIO;
2014

Abstract

Background/Aims: The aim of the present study is the analysis of risk factors of postoperative pancreatic fistula (POPF) and of clinical outcome after pancreatoduodenectomy (PD) in a retrospective multicentric review of the patient cohort. Methodology: From January 2003 to July 2013 143 patients underwent PD: 138 cases were included and 3 groups were identified according to the different types of anastomosis: Group 1 invaginating end-to-end pancreatojejunostomy, Group 2 end-to-side pancreatojejunostomy with duct-to-mucosa anastomosis, Group 3 end-to-side pancreatogastrostomy. Results: Twenty-one % of patients developed POPF, 16% in Group 1, 27% in Group 2, 12% in Group 3. Forty % grade A, 13% grade B and 47% grade C total POPE It results that POPF occurred in 16% of hard and in 40% of soft pancreatic texture; in 11.4% of dilated Wirsung versus 30.8% of non dilated (p=0.007). Overall actuarial 1 and 3 year survival after PD is 69% and 48% respectively. Perioperative mortality is 5.8% overall, 17.85% for grade C. Conclusions: No differences have been found among surgical anastomosis techniques. Soft tissues seem to increase, while dilated Wirsung seems to decrease POPF rate. The development of POPF increase morbidity but it doesn't affect overall survival, more strictly related to tumour histopathology
Articolo in rivista - Articolo scientifico
Aged; Female; Humans; Italy; Kaplan-Meier Estimate; Male; Middle Aged; Monaco; Pancreatic Diseases; Pancreatic Fistula; Pancreaticoduodenectomy; Retrospective Studies; Risk Assessment; Risk Factors; Time Factors; Treatment Outcome
English
2014
61
132
1124
1132
none
DE CARLIS, L., Sguinzi, R., Ferla, F., Di Sandro, S., Dorobantu, B., De Carlis, R., et al. (2014). Pancreatoduodenectomy: Risk Factors of Postoperative Pancreatic Fistula. HEPATO-GASTROENTEROLOGY, 61(132), 1124-1132 [10.5754/hge131005].
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Utilizza questo identificativo per citare o creare un link a questo documento: https://hdl.handle.net/10281/100995
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