Predictive Factors for Postoperative Pancreatic Fistula—A Swedish Nationwide Register-Based Study
Williamsson, C. LU ; Stenvall, K. ; Wennerblom, J. ; Andersson, R. LU ; Andersson, B. LU
and Tingstedt, B.
LU
(2020)
In World Journal of Surgery
44(12).
p.4207-4213
- Abstract
Background: A serious complication after pancreatoduodenectomy (PD) is postoperative pancreatic fistula (POPF). The aim of this study was to analyse the incidence and predictive factors for POPF by using a large nationwide cohort. Methods: Data from the Swedish National Registry for Pancreatic and Periampullary Cancer for all patients undergoing a PD from 2010 until 30th June 2018 were collected. The material was analysed in two groups, no POPF and clinically relevant (grade B and C) POPF. Results: A total of 2503 patients underwent PD, of which 245 (10%) developed POPF. Patients with POPF had significantly more overall complications (Clavien Dindo ≥3a, 75% vs. 21%, p < 0.001) and longer hospital stay (median 23 [16–35] vs. 11... (More)
Background: A serious complication after pancreatoduodenectomy (PD) is postoperative pancreatic fistula (POPF). The aim of this study was to analyse the incidence and predictive factors for POPF by using a large nationwide cohort. Methods: Data from the Swedish National Registry for Pancreatic and Periampullary Cancer for all patients undergoing a PD from 2010 until 30th June 2018 were collected. The material was analysed in two groups, no POPF and clinically relevant (grade B and C) POPF. Results: A total of 2503 patients underwent PD, of which 245 (10%) developed POPF. Patients with POPF had significantly more overall complications (Clavien Dindo ≥3a, 75% vs. 21%, p < 0.001) and longer hospital stay (median 23 [16–35] vs. 11 [8–15], p < 0.001) than patients without POPF. The risk of POPF was higher with increased BMI (OR 1.08, p < 0.001). Preoperative presence of diabetes (OR 0.52, p = 0.012) and preoperative biliary drainage (OR 0.34, p < 0.001) reduced the risk of POPF. Reconstruction with pancreaticojejunostomy caused a more than two folded increase in POPF compared with pancreaticogastrostomy (OR 2.41, p < 0.001). Weight gain ≥2 kg on postoperative day 1 was also a risk factor (OR 1.76, p < 0.001). Conclusion: A high BMI, a pancreaticojejunostomy and postoperative weight gain were risk factors for developing POPF. Diabetes or preoperative biliary drainage was protective.
(Less)
- author
- Williamsson, C.
LU
; Stenvall, K.
; Wennerblom, J.
; Andersson, R.
LU
; Andersson, B.
LU
and Tingstedt, B.
LU
- organization
- publishing date
- 2020
- type
- Contribution to journal
- publication status
- published
- subject
- in
- World Journal of Surgery
- volume
- 44
- issue
- 12
- pages
- 7 pages
- publisher
- Springer
- external identifiers
-
- pmid:32816084
- scopus:85089665457
- ISSN
- 0364-2313
- DOI
- 10.1007/s00268-020-05735-4
- language
- English
- LU publication?
- yes
- id
- 4196bd0c-72d3-4317-978b-ba7058629d00
- date added to LUP
- 2021-01-15 11:56:06
- date last changed
- 2024-06-13 05:27:27
@article{4196bd0c-72d3-4317-978b-ba7058629d00,
abstract = {{<p>Background: A serious complication after pancreatoduodenectomy (PD) is postoperative pancreatic fistula (POPF). The aim of this study was to analyse the incidence and predictive factors for POPF by using a large nationwide cohort. Methods: Data from the Swedish National Registry for Pancreatic and Periampullary Cancer for all patients undergoing a PD from 2010 until 30th June 2018 were collected. The material was analysed in two groups, no POPF and clinically relevant (grade B and C) POPF. Results: A total of 2503 patients underwent PD, of which 245 (10%) developed POPF. Patients with POPF had significantly more overall complications (Clavien Dindo ≥3a, 75% vs. 21%, p < 0.001) and longer hospital stay (median 23 [16–35] vs. 11 [8–15], p < 0.001) than patients without POPF. The risk of POPF was higher with increased BMI (OR 1.08, p < 0.001). Preoperative presence of diabetes (OR 0.52, p = 0.012) and preoperative biliary drainage (OR 0.34, p < 0.001) reduced the risk of POPF. Reconstruction with pancreaticojejunostomy caused a more than two folded increase in POPF compared with pancreaticogastrostomy (OR 2.41, p < 0.001). Weight gain ≥2 kg on postoperative day 1 was also a risk factor (OR 1.76, p < 0.001). Conclusion: A high BMI, a pancreaticojejunostomy and postoperative weight gain were risk factors for developing POPF. Diabetes or preoperative biliary drainage was protective.</p>}},
author = {{Williamsson, C. and Stenvall, K. and Wennerblom, J. and Andersson, R. and Andersson, B. and Tingstedt, B.}},
issn = {{0364-2313}},
language = {{eng}},
number = {{12}},
pages = {{4207--4213}},
publisher = {{Springer}},
series = {{World Journal of Surgery}},
title = {{Predictive Factors for Postoperative Pancreatic Fistula—A Swedish Nationwide Register-Based Study}},
url = {{http://dx.doi.org/10.1007/s00268-020-05735-4}},
doi = {{10.1007/s00268-020-05735-4}},
volume = {{44}},
year = {{2020}},
}