Visceral Obesity and Open Passive Drainage Increase the Risk of Pancreatic Fistula Following Distal Pancreatectomy.
Adult
Aged
Aged, 80 and over
Drainage
/ adverse effects
Female
Humans
Laparoscopy
/ adverse effects
Logistic Models
Male
Middle Aged
Multivariate Analysis
Obesity, Abdominal
/ complications
Pancreatectomy
/ adverse effects
Pancreatic Diseases
/ diagnostic imaging
Pancreatic Fistula
/ etiology
Pancreatic Neoplasms
/ diagnostic imaging
Postoperative Complications
/ etiology
Retrospective Studies
Risk Factors
Tomography, X-Ray Computed
Young Adult
Abdominal drainage
Distal pancreatectomy
Postoperative pancreatic fistula
Visceral obesity
Journal
Journal of gastrointestinal surgery : official journal of the Society for Surgery of the Alimentary Tract
ISSN: 1873-4626
Titre abrégé: J Gastrointest Surg
Pays: United States
ID NLM: 9706084
Informations de publication
Date de publication:
07 2019
07 2019
Historique:
received:
07
04
2018
accepted:
10
07
2018
pubmed:
19
8
2018
medline:
22
7
2020
entrez:
19
8
2018
Statut:
ppublish
Résumé
The predictive risk factors of clinically relevant pancreatic fistula (CR-PF) following distal pancreatectomy (DP) remain to be identified. This is a retrospective cohort analysis of a single-institution database of patients undergoing DP, taking into account usual demographic, operative, and pathologic variables and visceral fat area (VFA), total muscle area (TMA), and surface muscle index (SMI) measured on preoperative CT scan. The primary end point was CR-PF. All variables associated with a p value < 0.05 on univariate analysis were included in a logistic regression model for multivariate analysis. From 2012 to 2016, 208 patients operated by 4 pancreatic surgeons underwent DP including 32 (15%) who developed CR-PF. Risk factors of CR-PF on univariate analysis were: BMI ≥ 25 kg/m Visceral obesity, blood loss ≥ 225 ml and open passive drainage significantly increase the risk of CR-PF following DP.
Sections du résumé
BACKGROUND
The predictive risk factors of clinically relevant pancreatic fistula (CR-PF) following distal pancreatectomy (DP) remain to be identified.
METHODS
This is a retrospective cohort analysis of a single-institution database of patients undergoing DP, taking into account usual demographic, operative, and pathologic variables and visceral fat area (VFA), total muscle area (TMA), and surface muscle index (SMI) measured on preoperative CT scan. The primary end point was CR-PF. All variables associated with a p value < 0.05 on univariate analysis were included in a logistic regression model for multivariate analysis.
RESULTS
From 2012 to 2016, 208 patients operated by 4 pancreatic surgeons underwent DP including 32 (15%) who developed CR-PF. Risk factors of CR-PF on univariate analysis were: BMI ≥ 25 kg/m
CONCLUSIONS
Visceral obesity, blood loss ≥ 225 ml and open passive drainage significantly increase the risk of CR-PF following DP.
Identifiants
pubmed: 30120668
doi: 10.1007/s11605-018-3878-7
pii: 10.1007/s11605-018-3878-7
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
1414-1424Références
Ann Surg. 1999 May;229(5):693-8; discussion 698-700
pubmed: 10235528
Ann Surg. 2004 Aug;240(2):205-13
pubmed: 15273542
J Appl Physiol (1985). 2004 Dec;97(6):2333-8
pubmed: 15310748
Surgery. 2005 Feb;137(2):180-5
pubmed: 15674199
Br J Surg. 2005 May;92(5):539-46
pubmed: 15852419
Surgery. 2005 Jul;138(1):8-13
pubmed: 16003309
Arch Surg. 2006 Nov;141(11):1071-6; discussion 1076
pubmed: 17116799
Surgery. 2007 Jul;142(1):20-5
pubmed: 17629996
Surgery. 2007 Nov;142(5):761-8
pubmed: 17981197
HPB (Oxford). 2005;7(2):93-8
pubmed: 18333170
Lancet Oncol. 2008 Jul;9(7):629-35
pubmed: 18539529
Appl Physiol Nutr Metab. 2008 Oct;33(5):997-1006
pubmed: 18923576
Ann Surg. 2009 Jan;249(1):97-104
pubmed: 19106683
Trials. 2009 Jul 26;10:58
pubmed: 19630998
Br J Surg. 2011 Feb;98(2):268-74
pubmed: 20960457
HPB (Oxford). 2010 Dec;12(10):696-702
pubmed: 21083795
World J Surg. 2011 May;35(5):1110-7
pubmed: 21387132
J Am Med Dir Assoc. 2011 May;12(4):249-56
pubmed: 21527165
Lancet. 2011 Apr 30;377(9776):1514-22
pubmed: 21529927
Ann Surg. 2011 Nov;254(5):702-7; discussion 707-8
pubmed: 22042466
J Invest Surg. 2012 Jun;25(3):169-73
pubmed: 22583013
Ann Surg. 2012 Jul;256(1):139-45
pubmed: 22609844
J Am Coll Surg. 2013 Jan;216(1):1-14
pubmed: 23122535
J Hepatobiliary Pancreat Sci. 2013 Jun;20(5):538-44
pubmed: 23430057
N Engl J Med. 2014 May 22;370(21):2014-22
pubmed: 24849084
Ann Surg. 2015 Jun;261(6):1173-83
pubmed: 24950264
J Gastrointest Surg. 2014 Nov;18(11):2009-15
pubmed: 25238815
Surg Today. 2015 Jun;45(6):708-14
pubmed: 25331230
Ann Surg. 2015 Jun;261(6):1191-7
pubmed: 25371115
J Surg Oncol. 2015 May;111(6):771-5
pubmed: 25556324
Int J Colorectal Dis. 2015 Jul;30(7):875-82
pubmed: 25772271
Ann Surg. 2016 Feb;263(2):e20-1
pubmed: 25894415
World J Gastroenterol. 2015 Jun 21;21(23):7218-24
pubmed: 26109808
Pancreatology. 2015 Jul-Aug;15(4):380-6
pubmed: 26118649
J Am Coll Surg. 2015 Sep;221(3):689-98
pubmed: 26296680
Ann Surg Oncol. 2016 Feb;23(2):365-74
pubmed: 26493758
Clin Transplant. 2016 Mar;30(3):289-94
pubmed: 26717257
Br J Surg. 2016 Mar;103(4):434-42
pubmed: 26780231
Am J Surg. 2016 May;211(5):871-6
pubmed: 27046794
J Gastrointest Surg. 2016 Sep;20(9):1586-94
pubmed: 27126054
Ann Surg. 2016 Nov;264(5):723-730
pubmed: 27455155
Surgery. 2016 Nov;160(5):1271-1278
pubmed: 27498300
Ann Surg. 2016 Sep;264(3):528-37
pubmed: 27513157
JAMA Surg. 2017 Feb 1;152(2):150-155
pubmed: 27784046
Clin Nutr Res. 2016 Oct;5(4):279-289
pubmed: 27812517
Surgery. 2017 Mar;161(3):584-591
pubmed: 28040257
J Am Coll Surg. 2017 Aug;225(2):226-234.e2
pubmed: 28414116
Ann Surg. 2017 Sep;266(3):421-431
pubmed: 28692468
Ann Surg. 2019 Jan;269(1):143-149
pubmed: 28857813