Pancreatic fistula following pancreaticoduodenectomy

Clinical predictors and patient outcomes

C. Schmidt, Jennifer Choi, Emilie S. Powell, Constantin Yiannoutsos, Nicholas Zyromski, Attila Nakeeb, Henry A. Pitt, Eric A. Wiebke, James A. Madura, Keith D. Lillemoe

Research output: Contribution to journalArticle

67 Citations (Scopus)

Abstract

Pancreatic fistula continues to be a common complication following PD. This study seeks to identify clinical factors which may predict pancreatic fistula (PF) and evaluate the effect of PF on outcomes following pancreaticoduodenectomy (PD). We performed a retrospective analysis of a clinical database at an academic tertiary care hospital with a high volume of pancreatic surgery. Five hundred ten consecutive patients underwent PD, and PF occurred in 46 patients (9). Perioperative mortality of patients with PF was 0. Forty-five of 46 PF (98) closed without reoperation with a mean time to closure of 34 days. Patients who developed PF showed a higher incidence of wound infection, intra-abdominal abscess, need for reoperation, and hospital length of stay. Multivariate analysis demonstrated an invaginated pancreatic anastomosis and closed suction intraperitoneal drainage were associated with PF whereas a diagnosis of chronic pancreatitis and endoscopic stenting conferred protection. Development of PF following PD in this series was predicted by gender, preoperative stenting, pancreatic anastomotic technique, and pancreas pathology. Outcomes in patients with PF are remarkable for a higher rate of septic complications, longer hospital stays, but in this study, no increased mortality.

Original languageEnglish
Article number404520
JournalHPB Surgery
DOIs
StatePublished - 2009

Fingerprint

Pancreatic Fistula
Pancreaticoduodenectomy
Length of Stay
Reoperation
Abdominal Abscess
Mortality
Chronic Pancreatitis
Suction
Wound Infection
Tertiary Healthcare
Tertiary Care Centers
Pancreas
Multivariate Analysis
Databases
Pathology

ASJC Scopus subject areas

  • Hepatology
  • Surgery

Cite this

Pancreatic fistula following pancreaticoduodenectomy : Clinical predictors and patient outcomes. / Schmidt, C.; Choi, Jennifer; Powell, Emilie S.; Yiannoutsos, Constantin; Zyromski, Nicholas; Nakeeb, Attila; Pitt, Henry A.; Wiebke, Eric A.; Madura, James A.; Lillemoe, Keith D.

In: HPB Surgery, 2009.

Research output: Contribution to journalArticle

@article{4d62697fda98468297ccda6814619323,
title = "Pancreatic fistula following pancreaticoduodenectomy: Clinical predictors and patient outcomes",
abstract = "Pancreatic fistula continues to be a common complication following PD. This study seeks to identify clinical factors which may predict pancreatic fistula (PF) and evaluate the effect of PF on outcomes following pancreaticoduodenectomy (PD). We performed a retrospective analysis of a clinical database at an academic tertiary care hospital with a high volume of pancreatic surgery. Five hundred ten consecutive patients underwent PD, and PF occurred in 46 patients (9). Perioperative mortality of patients with PF was 0. Forty-five of 46 PF (98) closed without reoperation with a mean time to closure of 34 days. Patients who developed PF showed a higher incidence of wound infection, intra-abdominal abscess, need for reoperation, and hospital length of stay. Multivariate analysis demonstrated an invaginated pancreatic anastomosis and closed suction intraperitoneal drainage were associated with PF whereas a diagnosis of chronic pancreatitis and endoscopic stenting conferred protection. Development of PF following PD in this series was predicted by gender, preoperative stenting, pancreatic anastomotic technique, and pancreas pathology. Outcomes in patients with PF are remarkable for a higher rate of septic complications, longer hospital stays, but in this study, no increased mortality.",
author = "C. Schmidt and Jennifer Choi and Powell, {Emilie S.} and Constantin Yiannoutsos and Nicholas Zyromski and Attila Nakeeb and Pitt, {Henry A.} and Wiebke, {Eric A.} and Madura, {James A.} and Lillemoe, {Keith D.}",
year = "2009",
doi = "10.1155/2009/404520",
language = "English",
journal = "HPB Surgery",
issn = "0894-8569",
publisher = "Hindawi Publishing Corporation",

}

TY - JOUR

T1 - Pancreatic fistula following pancreaticoduodenectomy

T2 - Clinical predictors and patient outcomes

AU - Schmidt, C.

AU - Choi, Jennifer

AU - Powell, Emilie S.

AU - Yiannoutsos, Constantin

AU - Zyromski, Nicholas

AU - Nakeeb, Attila

AU - Pitt, Henry A.

AU - Wiebke, Eric A.

AU - Madura, James A.

AU - Lillemoe, Keith D.

PY - 2009

Y1 - 2009

N2 - Pancreatic fistula continues to be a common complication following PD. This study seeks to identify clinical factors which may predict pancreatic fistula (PF) and evaluate the effect of PF on outcomes following pancreaticoduodenectomy (PD). We performed a retrospective analysis of a clinical database at an academic tertiary care hospital with a high volume of pancreatic surgery. Five hundred ten consecutive patients underwent PD, and PF occurred in 46 patients (9). Perioperative mortality of patients with PF was 0. Forty-five of 46 PF (98) closed without reoperation with a mean time to closure of 34 days. Patients who developed PF showed a higher incidence of wound infection, intra-abdominal abscess, need for reoperation, and hospital length of stay. Multivariate analysis demonstrated an invaginated pancreatic anastomosis and closed suction intraperitoneal drainage were associated with PF whereas a diagnosis of chronic pancreatitis and endoscopic stenting conferred protection. Development of PF following PD in this series was predicted by gender, preoperative stenting, pancreatic anastomotic technique, and pancreas pathology. Outcomes in patients with PF are remarkable for a higher rate of septic complications, longer hospital stays, but in this study, no increased mortality.

AB - Pancreatic fistula continues to be a common complication following PD. This study seeks to identify clinical factors which may predict pancreatic fistula (PF) and evaluate the effect of PF on outcomes following pancreaticoduodenectomy (PD). We performed a retrospective analysis of a clinical database at an academic tertiary care hospital with a high volume of pancreatic surgery. Five hundred ten consecutive patients underwent PD, and PF occurred in 46 patients (9). Perioperative mortality of patients with PF was 0. Forty-five of 46 PF (98) closed without reoperation with a mean time to closure of 34 days. Patients who developed PF showed a higher incidence of wound infection, intra-abdominal abscess, need for reoperation, and hospital length of stay. Multivariate analysis demonstrated an invaginated pancreatic anastomosis and closed suction intraperitoneal drainage were associated with PF whereas a diagnosis of chronic pancreatitis and endoscopic stenting conferred protection. Development of PF following PD in this series was predicted by gender, preoperative stenting, pancreatic anastomotic technique, and pancreas pathology. Outcomes in patients with PF are remarkable for a higher rate of septic complications, longer hospital stays, but in this study, no increased mortality.

UR - http://www.scopus.com/inward/record.url?scp=67650234482&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=67650234482&partnerID=8YFLogxK

U2 - 10.1155/2009/404520

DO - 10.1155/2009/404520

M3 - Article

JO - HPB Surgery

JF - HPB Surgery

SN - 0894-8569

M1 - 404520

ER -