| Autor: |
Mastalier B; Department of Surgery, Department of Functional Sciences, Faculty of General Medicine, Carol Davila University of Medicine and Pharmacy, 8 Eroii Sanitari Blvd., 050474 Bucharest, Romania.; General Surgery Clinic, Colentina Clinical Hospital, 020125 Bucharest, Romania., Cauni V; Urology Clinic, Colentina Clinical Hospital, 020125 Bucharest, Romania., Tihon C; General Surgery Clinic, Colentina Clinical Hospital, 020125 Bucharest, Romania., Septimiu Petrutescu M; General Surgery Clinic, Colentina Clinical Hospital, 020125 Bucharest, Romania., Ghita B; General Surgery Clinic, Colentina Clinical Hospital, 020125 Bucharest, Romania., Popescu V; Department of Surgery, Department of Functional Sciences, Faculty of General Medicine, Carol Davila University of Medicine and Pharmacy, 8 Eroii Sanitari Blvd., 050474 Bucharest, Romania.; General Surgery Clinic, Colentina Clinical Hospital, 020125 Bucharest, Romania., Andras D; Department of Surgery, Department of Functional Sciences, Faculty of General Medicine, Carol Davila University of Medicine and Pharmacy, 8 Eroii Sanitari Blvd., 050474 Bucharest, Romania.; General Surgery Clinic, Colentina Clinical Hospital, 020125 Bucharest, Romania., Radu IM; General Surgery Clinic, Colentina Clinical Hospital, 020125 Bucharest, Romania., Vlasceanu VG; General Surgery Clinic, Colentina Clinical Hospital, 020125 Bucharest, Romania., Floroiu MF; Anaesthesia Intensive Care Unit, Colentina Clinical Hospital, 020125 Bucharest, Romania., Draghici C; Anaesthesia Intensive Care Unit, Colentina Clinical Hospital, 020125 Bucharest, Romania., Botezatu C; Department of Surgery, Department of Functional Sciences, Faculty of General Medicine, Carol Davila University of Medicine and Pharmacy, 8 Eroii Sanitari Blvd., 050474 Bucharest, Romania.; General Surgery Clinic, Colentina Clinical Hospital, 020125 Bucharest, Romania., Cretoiu D; Fetal Medicine Excellence Research Center, Alessandrescu-Rusescu National Institute for Mother and Child Health, 020395 Bucharest, Romania.; Department of Genetics, Carol Davila University of Medicine and Pharmacy, 8 Eroii Sanitari Blvd., 050474 Bucharest, Romania., Varlas VN; Department of Obstetrics and Gynaecology, Filantropia Clinical Hospital, 011171 Bucharest, Romania.; Department of Obstetrics and Gynaecology, 'Carol Davila' University of Medicine and Pharmacy, 37 Dionisie Lupu St., 020021 Bucharest, Romania., Lazar AM; Department of Surgery, Department of Functional Sciences, Faculty of General Medicine, Carol Davila University of Medicine and Pharmacy, 8 Eroii Sanitari Blvd., 050474 Bucharest, Romania.; General Surgery Clinic, Colentina Clinical Hospital, 020125 Bucharest, Romania. |
| Abstrakt: |
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. |
