Reappraisal of post-pancreatectomy hemorrhage (PPH) classifications: do we need to redefine grades A and B?

Published on Aug 1, 2018in Hpb3.401
· DOI :10.1016/J.HPB.2018.01.013
Alvaro Andres Duarte Garces1
Estimated H-index: 1
(University of Verona),
Stefano Andrianello16
Estimated H-index: 16
(University of Verona)
+ 6 AuthorsClaudio Bassi110
Estimated H-index: 110
(University of Verona)
Abstract Background Post-pancreatectomy hemorrhage (PPH) remains a major complication. The aim of this study was to reappraise the International Study Group of Pancreatic Surgery (ISGPS) classification. Methods The clinical utility of the ISGPS classification was tested on consecutive pancreatic resections performed at the Pancreas Institute of the University of Verona Hospital. Results PPH occurred in 65 of the 2429 patients (6.8%) undergoing pancreatic resection. Outcome of patients without PPH and with grade A PPH were comparable in terms of mortality, length of stay, ICU stay and readmission. Patients with grade B late and mild and grade B early and severe PPH had similar hospital stay and mortality rates, but differed in relaparotomy rate (10.1 vs. 81.2%, p Conclusion Grade A PPH shared the same outcome of patients without PPH. Grade B PPH included two categories of patients with different treatment modalities. The use of “concomitant POPF” instead of “time of onset” segregated three discrete categories that differed significantly in terms of clinical outcomes and management.
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