Predictors of pancreatic fistula healing time after distal pancreatectomy.
outcome
pancreas
pancreatectomy
pancreatic fistula
surgery
Journal
Journal of hepato-biliary-pancreatic sciences
ISSN: 1868-6982
Titre abrégé: J Hepatobiliary Pancreat Sci
Pays: Japan
ID NLM: 101528587
Informations de publication
Date de publication:
Dec 2021
Dec 2021
Historique:
revised:
03
09
2020
received:
28
07
2020
accepted:
23
09
2020
pubmed:
16
10
2020
medline:
29
12
2021
entrez:
15
10
2020
Statut:
ppublish
Résumé
Postoperative pancreatic fistula (POPF) is common after distal pancreatectomy (DP). Whilst extensive investigation into potential predictors has been carried out, there is little evidence regarding POPF healing time. This is a retrospective analysis of all consecutive DPs performed at the Department of General and Pancreatic Surgery, University of Verona Hospital Trust, from 2015 to 2019. Perioperative variables were analyzed identifying possible predictors of POPF healing time defined as days between surgery and last drain removal due to POPF. A total of 496 patients were included. POPF rate was 28.2% and median POPF healing time was 30 days (95% CI 28-31). Independent predictors of POPF were body mass index (BMI) (OR 1.073, 95% CI 1.010-1.147, p = 0.040), operative time (OR 95% CI 1.002-1.009, P = .003), and postoperative acute pancreatitis (OR 3.793, 95% CI, 1.852-7.767, P < .001). Independent predictors of POPF healing time were female sex (HR 1.323, 95% CI 1.093-1.998, P = .042), preoperative pancreatic enzyme replacement therapy (HR 2.319, 95% CI 1.195-4.498, P = .013), ASA score 3 (HR 0.278, 95% CI 0.119-0.646, P = .003), pancreatic transection with ultrasonic dissector (HR 0.605, 95% CI 0.404-0.907, P = .015), and positive drain cultures (HR 0.635, 95% CI 0.443-0.910, P = .013). POPF healing after DP is a slow process since only half of patients recover within 30 days of surgery. A longer healing time can be predicted early in the postoperative period with significant implications in therapeutic choices.
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
1076-1088Subventions
Organisme : Associazione Italiana per la Ricerca sul Cancro
ID : n.12182
Organisme : Associazione Italiana per la Ricerca sul Cancro
ID : n.17132
Organisme : Italian Ministry of Health
ID : FIMPCUP_J33G13000210001
Organisme : FP7 European Community Grant Cam-Pac
ID : n.602783
Informations de copyright
© 2020 Japanese Society of Hepato-Biliary-Pancreatic Surgery.
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