Predictive Factors Associated with Complications after Laparoscopic Distal Pancreatectomy
Although laparoscopic distal pancreatectomy (LDP) has become more popular, the postoperative complication rate remains high. We sought to identify the risk factors for post-LDP complications. We examined 1227 patients who underwent LDP between March 2005 and December 2015 at a single large-volume ce...
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| Format: | Article |
| Language: | English |
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MDPI AG
2020-08-01
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| Series: | Journal of Clinical Medicine |
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| Online Access: | https://www.mdpi.com/2077-0383/9/9/2766 |
| _version_ | 1797555475078709248 |
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| author | Ki Byung Song Sarang Hong Hwa Jung Kim Yejong Park Jaewoo Kwon Woohyung Lee Eunsung Jun Jae Hoon Lee Dae Wook Hwang Song Cheol Kim |
| author_facet | Ki Byung Song Sarang Hong Hwa Jung Kim Yejong Park Jaewoo Kwon Woohyung Lee Eunsung Jun Jae Hoon Lee Dae Wook Hwang Song Cheol Kim |
| author_sort | Ki Byung Song |
| collection | DOAJ |
| description | Although laparoscopic distal pancreatectomy (LDP) has become more popular, the postoperative complication rate remains high. We sought to identify the risk factors for post-LDP complications. We examined 1227 patients who underwent LDP between March 2005 and December 2015 at a single large-volume center. We used logistic regression for the analysis. The overall (13.2%) and major (3.3%) complication rates were determined. Postoperative pancreatic fistula was the most frequent complication, and 58 patients (4.7%) had clinically significant (grade B) pancreatic fistulas. No 90-day mortality was recorded. Long operative time (≥200 min), large estimated blood loss (≥320 mL), LDP performed by an inexperienced surgeon (<50 cases), and concomitant splenectomy were identified as risk factors for overall complications using a logistic regression model. For major complications, male sex (<i>p</i> = 0.020), long operative time (<i>p</i> = 0.005), and LDP performed by an inexperienced surgeon (<i>p</i> = 0.026) were significant predictive factors. Using logistic regression analysis, surgery-related factors, including long operative time and LDP performed by an inexperienced surgeon, were correlated with overall and major complications of LDP. As LDP is a technically challenging procedure, surgery-related variables emerged as the main risk factors for postoperative complications. Appropriate patient selection and sufficient surgeon experience may be essential to reduce the complications of LDP. |
| first_indexed | 2024-03-10T16:48:02Z |
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| id | doaj.art-9eabfc024cc44d72b32d2c68c3f8f244 |
| institution | Directory Open Access Journal |
| issn | 2077-0383 |
| language | English |
| last_indexed | 2024-03-10T16:48:02Z |
| publishDate | 2020-08-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Journal of Clinical Medicine |
| spelling | doaj.art-9eabfc024cc44d72b32d2c68c3f8f2442023-11-20T11:27:13ZengMDPI AGJournal of Clinical Medicine2077-03832020-08-0199276610.3390/jcm9092766Predictive Factors Associated with Complications after Laparoscopic Distal PancreatectomyKi Byung Song0Sarang Hong1Hwa Jung Kim2Yejong Park3Jaewoo Kwon4Woohyung Lee5Eunsung Jun6Jae Hoon Lee7Dae Wook Hwang8Song Cheol Kim9Division of Hepatobiliary and Pancreatic Surgery, Department of Surgery, Asan Medical Center, University of Ulsan College of Medicine, 88 Olympic-ro 43-gil, Songpa-gu, Seoul 05505, KoreaDivision of Hepatobiliary and Pancreatic Surgery, Department of Surgery, Asan Medical Center, University of Ulsan College of Medicine, 88 Olympic-ro 43-gil, Songpa-gu, Seoul 05505, KoreaDepartment of Clinical Epidemiology and Biostatistics, Asan Medical Center, University of Ulsan College of Medicine, 88 Olympic-ro 43-gil, Songpa-gu, Seoul 05505, KoreaDivision of Hepatobiliary and Pancreatic Surgery, Department of Surgery, Asan Medical Center, University of Ulsan College of Medicine, 88 Olympic-ro 43-gil, Songpa-gu, Seoul 05505, KoreaDivision of Hepatobiliary and Pancreatic Surgery, Department of Surgery, Asan Medical Center, University of Ulsan College of Medicine, 88 Olympic-ro 43-gil, Songpa-gu, Seoul 05505, KoreaDivision of Hepatobiliary and Pancreatic Surgery, Department of Surgery, Asan Medical Center, University of Ulsan College of Medicine, 88 Olympic-ro 43-gil, Songpa-gu, Seoul 05505, KoreaDivision of Hepatobiliary and Pancreatic Surgery, Department of Surgery, Asan Medical Center, University of Ulsan College of Medicine, 88 Olympic-ro 43-gil, Songpa-gu, Seoul 05505, KoreaDivision of Hepatobiliary and Pancreatic Surgery, Department of Surgery, Asan Medical Center, University of Ulsan College of Medicine, 88 Olympic-ro 43-gil, Songpa-gu, Seoul 05505, KoreaDivision of Hepatobiliary and Pancreatic Surgery, Department of Surgery, Asan Medical Center, University of Ulsan College of Medicine, 88 Olympic-ro 43-gil, Songpa-gu, Seoul 05505, KoreaDivision of Hepatobiliary and Pancreatic Surgery, Department of Surgery, Asan Medical Center, University of Ulsan College of Medicine, 88 Olympic-ro 43-gil, Songpa-gu, Seoul 05505, KoreaAlthough laparoscopic distal pancreatectomy (LDP) has become more popular, the postoperative complication rate remains high. We sought to identify the risk factors for post-LDP complications. We examined 1227 patients who underwent LDP between March 2005 and December 2015 at a single large-volume center. We used logistic regression for the analysis. The overall (13.2%) and major (3.3%) complication rates were determined. Postoperative pancreatic fistula was the most frequent complication, and 58 patients (4.7%) had clinically significant (grade B) pancreatic fistulas. No 90-day mortality was recorded. Long operative time (≥200 min), large estimated blood loss (≥320 mL), LDP performed by an inexperienced surgeon (<50 cases), and concomitant splenectomy were identified as risk factors for overall complications using a logistic regression model. For major complications, male sex (<i>p</i> = 0.020), long operative time (<i>p</i> = 0.005), and LDP performed by an inexperienced surgeon (<i>p</i> = 0.026) were significant predictive factors. Using logistic regression analysis, surgery-related factors, including long operative time and LDP performed by an inexperienced surgeon, were correlated with overall and major complications of LDP. As LDP is a technically challenging procedure, surgery-related variables emerged as the main risk factors for postoperative complications. Appropriate patient selection and sufficient surgeon experience may be essential to reduce the complications of LDP.https://www.mdpi.com/2077-0383/9/9/2766laparoscopic distal pancreatectomyrisk factorscomplicationsurgery-related factorspostoperative pancreatic fistula |
| spellingShingle | Ki Byung Song Sarang Hong Hwa Jung Kim Yejong Park Jaewoo Kwon Woohyung Lee Eunsung Jun Jae Hoon Lee Dae Wook Hwang Song Cheol Kim Predictive Factors Associated with Complications after Laparoscopic Distal Pancreatectomy Journal of Clinical Medicine laparoscopic distal pancreatectomy risk factors complication surgery-related factors postoperative pancreatic fistula |
| title | Predictive Factors Associated with Complications after Laparoscopic Distal Pancreatectomy |
| title_full | Predictive Factors Associated with Complications after Laparoscopic Distal Pancreatectomy |
| title_fullStr | Predictive Factors Associated with Complications after Laparoscopic Distal Pancreatectomy |
| title_full_unstemmed | Predictive Factors Associated with Complications after Laparoscopic Distal Pancreatectomy |
| title_short | Predictive Factors Associated with Complications after Laparoscopic Distal Pancreatectomy |
| title_sort | predictive factors associated with complications after laparoscopic distal pancreatectomy |
| topic | laparoscopic distal pancreatectomy risk factors complication surgery-related factors postoperative pancreatic fistula |
| url | https://www.mdpi.com/2077-0383/9/9/2766 |
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