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Related Concept Videos

Chronic Pancreatitis II: Collaborative Care01:29

Chronic Pancreatitis II: Collaborative Care

92
The management of chronic pancreatitis is multifaceted, involving a comprehensive approach that includes thorough assessment, diagnostic testing, and a variety of management strategies.
Assessment:
92
  1. Home
  3. Research Domains
  5. Biomedical And Clinical Sciences
  7. Oncology And Carcinogenesis
  9. Predictive And Prognostic Markers
  11. Contemporary Outcomes Of Grade-c Postoperative Pancreatic Fistula In A Nationwide Database.

Contemporary Outcomes of Grade-C Postoperative Pancreatic Fistula in a Nationwide Database.

Kevin M Turner1, Aaron M Delman1, Szu-Aun Lim1

  • 1Department of Surgery, University of Cincinnati College of Medicine, Cincinnati, Ohio.

The Journal of Surgical Research
|February 2, 2024

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View abstract on PubMed

Summary
This summary is machine-generated.

Grade C postoperative pancreatic fistulas (POPFs) occur in 1.2% of pancreaticoduodenectomy cases and are linked to increased morbidity. Diabetes mellitus is a significant risk factor for developing grade C POPFs, necessitating improved management strategies.

Area of Science:

  • Surgical Oncology
  • Gastroenterology
  • Clinical Outcomes Research

Background:

  • Postoperative pancreatic fistulas (POPFs) are significant complications after pancreaticoduodenectomy.
  • Grade C POPFs represent a severe subset of these complications, carrying substantial morbidity.
  • Quantifying the incidence and risk factors for grade C POPF is crucial for improving patient outcomes.

Purpose of the Study:

  • To determine the incidence of grade C POPFs in a large national cohort.
  • To identify risk factors associated with grade C POPFs following pancreaticoduodenectomy.
  • To compare the characteristics and outcomes of grade C POPFs versus grade B POPFs.

Main Methods:

  • Analysis of the National Surgical Quality Improvement Program database (2014-2020).
Keywords:
Grade-C POPFPancreatic fistulaPancreaticoduodenectomy

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  • Inclusion of patients undergoing elective pancreaticoduodenectomy.
  • Comparison of outcomes between patients with clinically relevant grade B POPF and grade C POPF.

    • Main Results:

    • A total of 26,552 patients were analyzed; 1.2% developed grade C POPF.
    • The incidence of grade C POPF remained stable over time, while grade B POPF increased.
    • Grade C POPF was associated with significantly higher morbidity, including delayed gastric emptying, infections, and renal complications.
    • Diabetes mellitus was identified as an independent risk factor for grade C POPF (OR 1.41, P=0.02).

    Conclusions:

    • Grade C POPFs occur in approximately 1% of pancreaticoduodenectomy cases and are associated with severe morbidity.
    • Diabetes mellitus is a key risk factor for developing grade C POPF.
    • Despite advances in management, grade C POPFs necessitate further research into mitigation strategies to reduce associated mortality and morbidity.