Postoperative Acute Pancreatitis Following Pancreaticoduodenectomy: A Determinant of Fistula Potentially Driven by the Intraoperative Fluid Management.

Published on Nov 1, 2018in Annals of Surgery10.13
· DOI :10.1097/SLA.0000000000002900
Elisa Bannone3
Estimated H-index: 3
(University of Verona),
Stefano Andrianello16
Estimated H-index: 16
+ 4 AuthorsRoberto Salvia52
Estimated H-index: 52
Sources
Abstract
Objective:The aim of the study is to characterize postoperative acute pancreatitis (POAP).Summary Background Data:A standardized definition of POAP after pancreaticoduodenectomy (PD) has been recently proposed, but specific studies are lacking.Methods:The patients were extracted from the prospective
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Background In 2005, the International Study Group of Pancreatic Fistula developed a definition and grading of postoperative pancreatic fistula that has been accepted universally. Eleven years later, because postoperative pancreatic fistula remains one of the most relevant and harmful complications of pancreatic operation, the International Study Group of Pancreatic Fistula classification has become the gold standard in defining postoperative pancreatic fistula in clinical practice. The aim of th...
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#2N. Samiei (University of Freiburg)H-Index: 1
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Background Morbidity after pancreas resection is still high with postoperative pancreatic fistulas (POPF) being the most frequent complication. However, exocrine insufficiency seems to protect from POPF. In clinical practice, patients showing increased postoperative systemic amylase concentrations appear to frequently develop POPF. We therefore retrospectively examined the occurrence of systemic amylase increase after pancreas resections and its association with the clinical course.
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#2Giulia David (University of Insubria)H-Index: 6
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Aims Anastomotic leakage after colorectal surgery is a severe complication. One possible cause of anastomotic leakage is insufficient vascular supply. The aim of this study was to evaluate the feasibility and the usefulness of intraoperative assessment of vascular anastomotic perfusion in colorectal surgery using indocyanine green (ICG)-enhanced fluorescence.
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Introduction International Study Group of Pancreatic Fistula (ISGPF) grade C postoperative pancreatic fistulas (POPF) are the greatest contributor to major morbidity and mortality following pancreatoduodenectomy (PD); however, their infrequent occurrence has hindered deeper analysis. This study sought to develop a predictive algorithm, which could facilitate effective management of this challenging complication.
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Abstract Introduction Postoperative pancreatic fistula (POPF) is the most significant cause of morbidity and mortality after pancreaticoduodenectomy (PD). We evaluated the role of postoperative serum lipase concentration in ruling out POPF in the immediate post-operative period. Materials and methods We retrospectively analysed 98 consecutive PD performed between January 2009 and December 2014, investigating the correlation between postoperative day 1 (POD1) serum lipase concentration and POPF d...
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Abstract null null Background null The incidence of and risk factors for chyle leak, as defined by the 2017 International Study Group on Pancreatic Surgery, remain unknown. null null null Methods null MEDLINE, EMBASE, and Scopus were systematically searched for studies of patients undergoing pancreatectomy that reported chyle leak according to the 2017 International Study Group on Pancreatic Surgery definition. The primary outcomes were the incidence of overall and clinically relevant chyle leak...
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#1Ekaterina PetrovaH-Index: 5
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Abstract null null Background null Evidence on the optimal pancreatic anastomosis during pancreatoduodenectomy is inconclusive. Large multicenter and nationwide registries may provide additional insights. The study compared the practice and outcome of different pancreatic anastomoses during pancreatoduodenectomy, focusing on the rate of postoperative pancreatic fistula, in two large audits of pancreatic surgery. null null null Methods null Posthoc analysis of patients after pancreatoduodenectomy...
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#1Warangkana Lapisatepun (CMU: Chiang Mai University)H-Index: 1
#2Weerapong Wongsa (CMU: Chiang Mai University)
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Background null Postoperative pancreatic fistula (POPF) is one of the major complications after pancreaticoduodenectomy. There have been many studies into the risk factors determining POPF. Some studies have reported a higher peri-operative fluid balance associated with POPF, however, the pertinent findings remain controversial. The aims of this study were to determine risk factors of clinically relevant-post operative pancreatic fistula (CR-POPF) after pancreaticoduodenectomy and an association...
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#1Roberto Salvia (University of Verona)H-Index: 52
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BACKGROUND The application of postoperative pancreatic fistula (POPF) risk stratification and mitigation strategies requires an update of the protocol for an early drain removal after pancreaticoduodenectomy (PD). The aim of the study is to highlight the unreliability of a single drain fluid amylase (DFA) cutoff-based protocol in the setting of a risk-based drain management. METHODS The role of postoperative day one (POD1) DFA in predicting POPF was explored in the setting of both selective drai...
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Abstract Postoperative (or postpancreatectomy) acute pancreatitis (PPAP) in the pancreatic remnant has recently been recognized as a distinct complication entity that may occur after both partial pancreatoduodenectomy (PD) and distal pancreatectomy (DP). However, it remains unclear what constitutes PPAP. Moreover, the pathophysiologic events leading to PPAP are not fully understood and no internationally accepted definition of PPAP exists. Recent studies mostly used an early postoperative increa...
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#1Kim C. HonselmannH-Index: 10
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#1Jelle C van Dongen (EUR: Erasmus University Rotterdam)H-Index: 2
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PURPOSE Serum and drain amylase have been identified as important predictors of postoperative pancreatic fistula (POPF) and might be useful to guide postoperative drain management after pancreatoduodenectomy. We aimed to determine and compare the value of serum amylase and drain fluid amylase to predict postoperative pancreatic fistula after pancreatoduodenectomy. METHODS This retrospective cohort study included patients after pancreatoduodenectomy from 2012 to 2019. The primary endpoint of our ...
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#1Sivesh K. Kamarajah (University of Newcastle)H-Index: 16
#2James R. Bundred (University of Birmingham)H-Index: 8
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Background Many studies have explored factors relating to post-operative pancreatic fistula (POPF); however, the original definition (All-POPF) was revised to include only 'clinically relevant' (CR) POPF. This study identified variables associated with the two International Study Group on Pancreatic Surgery definitions to identify which variables are more strongly associated with CR-POPF. Methods A systematic review identified all studies reporting risk factors for POPF (using both International...
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#2Valentina Andreasi (UniSR: Vita-Salute San Raffaele University)H-Index: 8
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Abstract Background A fatty infiltration of the pancreas has been traditionally regarded as the main histological risk factor for postoperative pancreatic fistula, whereas the role of the secreting acinar compartment has been poorly investigated. The aim of this study was to evaluate the role of acinar content at pancreatic resection margin in the development of clinically relevant postoperative pancreatic fistula and clinically relevant postoperative acute pancreatitis after pancreaticoduodenec...
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