Pancreaticogastrostomy versus Pancreaticojejunostomy and the Proposal of a New Postoperative Pancreatic Fistula Risk Score
Despite the substantial decrease in mortality rates following a pancreaticoduodenectomy to less than 5%, morbidity rates remain significant, reaching even 73%. Postoperative pancreatic fistula is one of the most frequent major complications and is significantly associated with other complications, i...
| Main Authors: | , , , , , , , , , , , , , , |
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| Format: | Article |
| Language: | English |
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MDPI AG
2023-09-01
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| Series: | Journal of Clinical Medicine |
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| Online Access: | https://www.mdpi.com/2077-0383/12/19/6193 |
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| author | Bogdan Mastalier Victor Cauni Constantin Tihon Marius Septimiu Petrutescu Bogdan Ghita Valentin Popescu Dan Andras Ion Mircea Radu Vasile Gabriel Vlasceanu Marius Florian Floroiu Cristian Draghici Cristian Botezatu Dragos Cretoiu Valentin Nicolae Varlas Angela Madalina Lazar |
| author_facet | Bogdan Mastalier Victor Cauni Constantin Tihon Marius Septimiu Petrutescu Bogdan Ghita Valentin Popescu Dan Andras Ion Mircea Radu Vasile Gabriel Vlasceanu Marius Florian Floroiu Cristian Draghici Cristian Botezatu Dragos Cretoiu Valentin Nicolae Varlas Angela Madalina Lazar |
| author_sort | Bogdan Mastalier |
| collection | DOAJ |
| description | Despite the substantial decrease in mortality rates following a pancreaticoduodenectomy to less than 5%, morbidity rates remain significant, reaching even 73%. Postoperative pancreatic fistula is one of the most frequent major complications and is significantly associated with other complications, including patient death. Currently, there is no consensus regarding the ideal type of pancreatic anastomosis, as the question of the choice between a pancreaticogastrostomy and pancreaticojejunostomy is still open. Furthermore, worldwide implementation of an ideal pancreatic fistula risk prediction score is missing. Our study found several significant predictive factors for the postoperative occurrence of fistulas, such as the soft consistency of the pancreas, non-dilated Wirsung duct, important intraoperative blood loss, other perioperative complications, preoperative patient hypoalbuminemia, and patient weight loss. Our study also revealed that for patients who exhibit fistula risk factors, pancreaticogastrostomy demonstrates a significantly lower pancreatic fistula rate than pancreaticojejunostomy. The occurrence of pancreatic fistulas has been significantly associated with the development of other postoperative major complications, and patient death. As the current pancreatic fistula risk scores proposed by various authors have not been consensually validated, we propose a simple, easy-to-use, and sensitive score for the risk prediction of postoperative pancreatic fistula occurrence based on important predictors from statistical analyses that have also been found to be significant by most of the reported studies. The new pancreatic fistula risk score proposed by us could be extremely useful for improved therapeutic management of cephalic pancreaticoduodenectomy patients. |
| first_indexed | 2024-03-10T21:42:11Z |
| format | Article |
| id | doaj.art-d7695d1bd0384966b59f92b2f7707fc8 |
| institution | Directory Open Access Journal |
| issn | 2077-0383 |
| language | English |
| last_indexed | 2024-03-10T21:42:11Z |
| publishDate | 2023-09-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Journal of Clinical Medicine |
| spelling | doaj.art-d7695d1bd0384966b59f92b2f7707fc82023-11-19T14:35:23ZengMDPI AGJournal of Clinical Medicine2077-03832023-09-011219619310.3390/jcm12196193Pancreaticogastrostomy versus Pancreaticojejunostomy and the Proposal of a New Postoperative Pancreatic Fistula Risk ScoreBogdan Mastalier0Victor Cauni1Constantin Tihon2Marius Septimiu Petrutescu3Bogdan Ghita4Valentin Popescu5Dan Andras6Ion Mircea Radu7Vasile Gabriel Vlasceanu8Marius Florian Floroiu9Cristian Draghici10Cristian Botezatu11Dragos Cretoiu12Valentin Nicolae Varlas13Angela Madalina Lazar14Department of Surgery, Department of Functional Sciences, Faculty of General Medicine, Carol Davila University of Medicine and Pharmacy, 8 Eroii Sanitari Blvd., 050474 Bucharest, RomaniaUrology Clinic, Colentina Clinical Hospital, 020125 Bucharest, RomaniaGeneral Surgery Clinic, Colentina Clinical Hospital, 020125 Bucharest, RomaniaGeneral Surgery Clinic, Colentina Clinical Hospital, 020125 Bucharest, RomaniaGeneral Surgery Clinic, Colentina Clinical Hospital, 020125 Bucharest, RomaniaDepartment of Surgery, Department of Functional Sciences, Faculty of General Medicine, Carol Davila University of Medicine and Pharmacy, 8 Eroii Sanitari Blvd., 050474 Bucharest, RomaniaDepartment of Surgery, Department of Functional Sciences, Faculty of General Medicine, Carol Davila University of Medicine and Pharmacy, 8 Eroii Sanitari Blvd., 050474 Bucharest, RomaniaGeneral Surgery Clinic, Colentina Clinical Hospital, 020125 Bucharest, RomaniaGeneral Surgery Clinic, Colentina Clinical Hospital, 020125 Bucharest, RomaniaAnaesthesia Intensive Care Unit, Colentina Clinical Hospital, 020125 Bucharest, RomaniaAnaesthesia Intensive Care Unit, Colentina Clinical Hospital, 020125 Bucharest, RomaniaDepartment of Surgery, Department of Functional Sciences, Faculty of General Medicine, Carol Davila University of Medicine and Pharmacy, 8 Eroii Sanitari Blvd., 050474 Bucharest, RomaniaFetal Medicine Excellence Research Center, Alessandrescu-Rusescu National Institute for Mother and Child Health, 020395 Bucharest, RomaniaDepartment of Obstetrics and Gynaecology, Filantropia Clinical Hospital, 011171 Bucharest, RomaniaDepartment of Surgery, Department of Functional Sciences, Faculty of General Medicine, Carol Davila University of Medicine and Pharmacy, 8 Eroii Sanitari Blvd., 050474 Bucharest, RomaniaDespite the substantial decrease in mortality rates following a pancreaticoduodenectomy to less than 5%, morbidity rates remain significant, reaching even 73%. Postoperative pancreatic fistula is one of the most frequent major complications and is significantly associated with other complications, including patient death. Currently, there is no consensus regarding the ideal type of pancreatic anastomosis, as the question of the choice between a pancreaticogastrostomy and pancreaticojejunostomy is still open. Furthermore, worldwide implementation of an ideal pancreatic fistula risk prediction score is missing. Our study found several significant predictive factors for the postoperative occurrence of fistulas, such as the soft consistency of the pancreas, non-dilated Wirsung duct, important intraoperative blood loss, other perioperative complications, preoperative patient hypoalbuminemia, and patient weight loss. Our study also revealed that for patients who exhibit fistula risk factors, pancreaticogastrostomy demonstrates a significantly lower pancreatic fistula rate than pancreaticojejunostomy. The occurrence of pancreatic fistulas has been significantly associated with the development of other postoperative major complications, and patient death. As the current pancreatic fistula risk scores proposed by various authors have not been consensually validated, we propose a simple, easy-to-use, and sensitive score for the risk prediction of postoperative pancreatic fistula occurrence based on important predictors from statistical analyses that have also been found to be significant by most of the reported studies. The new pancreatic fistula risk score proposed by us could be extremely useful for improved therapeutic management of cephalic pancreaticoduodenectomy patients.https://www.mdpi.com/2077-0383/12/19/6193pancreaticoduodenectomypancreaticogastrostomypancreaticojejunostomypancreatic fistulapancreatic fistula risk scorepredictors |
| spellingShingle | Bogdan Mastalier Victor Cauni Constantin Tihon Marius Septimiu Petrutescu Bogdan Ghita Valentin Popescu Dan Andras Ion Mircea Radu Vasile Gabriel Vlasceanu Marius Florian Floroiu Cristian Draghici Cristian Botezatu Dragos Cretoiu Valentin Nicolae Varlas Angela Madalina Lazar Pancreaticogastrostomy versus Pancreaticojejunostomy and the Proposal of a New Postoperative Pancreatic Fistula Risk Score Journal of Clinical Medicine pancreaticoduodenectomy pancreaticogastrostomy pancreaticojejunostomy pancreatic fistula pancreatic fistula risk score predictors |
| title | Pancreaticogastrostomy versus Pancreaticojejunostomy and the Proposal of a New Postoperative Pancreatic Fistula Risk Score |
| title_full | Pancreaticogastrostomy versus Pancreaticojejunostomy and the Proposal of a New Postoperative Pancreatic Fistula Risk Score |
| title_fullStr | Pancreaticogastrostomy versus Pancreaticojejunostomy and the Proposal of a New Postoperative Pancreatic Fistula Risk Score |
| title_full_unstemmed | Pancreaticogastrostomy versus Pancreaticojejunostomy and the Proposal of a New Postoperative Pancreatic Fistula Risk Score |
| title_short | Pancreaticogastrostomy versus Pancreaticojejunostomy and the Proposal of a New Postoperative Pancreatic Fistula Risk Score |
| title_sort | pancreaticogastrostomy versus pancreaticojejunostomy and the proposal of a new postoperative pancreatic fistula risk score |
| topic | pancreaticoduodenectomy pancreaticogastrostomy pancreaticojejunostomy pancreatic fistula pancreatic fistula risk score predictors |
| url | https://www.mdpi.com/2077-0383/12/19/6193 |
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