Clinically Relevant Pancreatic Fistula after Pancreaticoduodenectomy: How We Do It
(1) Background: This study’s goals were to investigate possible risk factors for clinically relevant postoperative pancreatic fistula (POPF) grade B/C according to the updated definitions of the International Study Group of Pancreatic Surgery and to analyze possible treatment strategies; (2) Methods...
| Main Authors: | , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
MDPI AG
2023-01-01
|
| Series: | Biology |
| Subjects: | |
| Online Access: | https://www.mdpi.com/2079-7737/12/2/178 |
| _version_ | 1797622279012614144 |
|---|---|
| author | Jana Enderes Christiane Pillny Hanno Matthaei Steffen Manekeller Jörg C. Kalff Tim R. Glowka |
| author_facet | Jana Enderes Christiane Pillny Hanno Matthaei Steffen Manekeller Jörg C. Kalff Tim R. Glowka |
| author_sort | Jana Enderes |
| collection | DOAJ |
| description | (1) Background: This study’s goals were to investigate possible risk factors for clinically relevant postoperative pancreatic fistula (POPF) grade B/C according to the updated definitions of the International Study Group of Pancreatic Surgery and to analyze possible treatment strategies; (2) Methods: Between 2017 and 2021, 200 patients were analyzed regarding the development of POPF grade B/C with an emphasis on postoperative outcome and treatment strategies; (3) Results: POPF grade B/C was observed in 39 patients (19.5%). These patients were younger, mainly male, had fewer comorbidities and showed a higher body mass index. Also, they had lower CA-19 levels, a smaller tumor size and softer pancreatic parenchyma. They experienced a worse outcome without affecting the overall mortality rate (10% vs. 6%, <i>p</i> = 0.481), however, this lead to a prolonged postoperative stay (28 (32–36) d vs. 20 (15–28) d, <i>p</i> ≤ 0.001). The majority of patients with POPF grade B/C were able to receive conservative treatment, followed by drainage placement, endoscopic vacuum-assisted therapy (EVT) and surgery. Conservative treatment resulted in a shorter length of the postoperative stay (24 (22–28) d vs. 34 (26–43) d, <i>p</i> = 0.012); (4) Conclusions: Patients developing POPF grade B/C had a worse outcome; however, this did not affect the overall mortality rate. The majority of the patients were able to receive conservative treatment, resulting in a shorter length of their hospital stay. |
| first_indexed | 2024-03-11T09:07:57Z |
| format | Article |
| id | doaj.art-5bf57c6dc6e54dbcb567f21649aaabb8 |
| institution | Directory Open Access Journal |
| issn | 2079-7737 |
| language | English |
| last_indexed | 2024-03-11T09:07:57Z |
| publishDate | 2023-01-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Biology |
| spelling | doaj.art-5bf57c6dc6e54dbcb567f21649aaabb82023-11-16T19:12:41ZengMDPI AGBiology2079-77372023-01-0112217810.3390/biology12020178Clinically Relevant Pancreatic Fistula after Pancreaticoduodenectomy: How We Do ItJana Enderes0Christiane Pillny1Hanno Matthaei2Steffen Manekeller3Jörg C. Kalff4Tim R. Glowka5Department of Surgery, University Hospital Bonn, 53127 Bonn, GermanyDepartment of Surgery, University Hospital Bonn, 53127 Bonn, GermanyDepartment of Surgery, University Hospital Bonn, 53127 Bonn, GermanyDepartment of Surgery, University Hospital Bonn, 53127 Bonn, GermanyDepartment of Surgery, University Hospital Bonn, 53127 Bonn, GermanyDepartment of Surgery, University Hospital Bonn, 53127 Bonn, Germany(1) Background: This study’s goals were to investigate possible risk factors for clinically relevant postoperative pancreatic fistula (POPF) grade B/C according to the updated definitions of the International Study Group of Pancreatic Surgery and to analyze possible treatment strategies; (2) Methods: Between 2017 and 2021, 200 patients were analyzed regarding the development of POPF grade B/C with an emphasis on postoperative outcome and treatment strategies; (3) Results: POPF grade B/C was observed in 39 patients (19.5%). These patients were younger, mainly male, had fewer comorbidities and showed a higher body mass index. Also, they had lower CA-19 levels, a smaller tumor size and softer pancreatic parenchyma. They experienced a worse outcome without affecting the overall mortality rate (10% vs. 6%, <i>p</i> = 0.481), however, this lead to a prolonged postoperative stay (28 (32–36) d vs. 20 (15–28) d, <i>p</i> ≤ 0.001). The majority of patients with POPF grade B/C were able to receive conservative treatment, followed by drainage placement, endoscopic vacuum-assisted therapy (EVT) and surgery. Conservative treatment resulted in a shorter length of the postoperative stay (24 (22–28) d vs. 34 (26–43) d, <i>p</i> = 0.012); (4) Conclusions: Patients developing POPF grade B/C had a worse outcome; however, this did not affect the overall mortality rate. The majority of the patients were able to receive conservative treatment, resulting in a shorter length of their hospital stay.https://www.mdpi.com/2079-7737/12/2/178pancreaticoduodenectomyWhipplepancreatic fistulaendoscopic vacuum-assisted therapy |
| spellingShingle | Jana Enderes Christiane Pillny Hanno Matthaei Steffen Manekeller Jörg C. Kalff Tim R. Glowka Clinically Relevant Pancreatic Fistula after Pancreaticoduodenectomy: How We Do It Biology pancreaticoduodenectomy Whipple pancreatic fistula endoscopic vacuum-assisted therapy |
| title | Clinically Relevant Pancreatic Fistula after Pancreaticoduodenectomy: How We Do It |
| title_full | Clinically Relevant Pancreatic Fistula after Pancreaticoduodenectomy: How We Do It |
| title_fullStr | Clinically Relevant Pancreatic Fistula after Pancreaticoduodenectomy: How We Do It |
| title_full_unstemmed | Clinically Relevant Pancreatic Fistula after Pancreaticoduodenectomy: How We Do It |
| title_short | Clinically Relevant Pancreatic Fistula after Pancreaticoduodenectomy: How We Do It |
| title_sort | clinically relevant pancreatic fistula after pancreaticoduodenectomy how we do it |
| topic | pancreaticoduodenectomy Whipple pancreatic fistula endoscopic vacuum-assisted therapy |
| url | https://www.mdpi.com/2079-7737/12/2/178 |
| work_keys_str_mv | AT janaenderes clinicallyrelevantpancreaticfistulaafterpancreaticoduodenectomyhowwedoit AT christianepillny clinicallyrelevantpancreaticfistulaafterpancreaticoduodenectomyhowwedoit AT hannomatthaei clinicallyrelevantpancreaticfistulaafterpancreaticoduodenectomyhowwedoit AT steffenmanekeller clinicallyrelevantpancreaticfistulaafterpancreaticoduodenectomyhowwedoit AT jorgckalff clinicallyrelevantpancreaticfistulaafterpancreaticoduodenectomyhowwedoit AT timrglowka clinicallyrelevantpancreaticfistulaafterpancreaticoduodenectomyhowwedoit |