Are there preoperative factors related to a “soft pancreas” and are they predictive of pancreatic fistulas after pancreatic resection?
Purpose Soft pancreatic parenchyma is the most widely recognized risk factor for pancreatic fistula. We conducted this study to clarify if there are preoperative factors related to a soft pancreatic remnant and to establish if they are useful for predicting pancreatic fistula. Methods This was a ret...
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Veröffentlicht in: | Surgery today (Tokyo, Japan) Japan), 2015-06, Vol.45 (6), p.708-714 |
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creator | Casadei, Riccardo Ricci, Claudio Taffurelli, Giovanni D’Ambra, Marielda Pacilio, Carlo Alberto Ingaldi, Carlo Minni, Francesco |
description | Purpose
Soft pancreatic parenchyma is the most widely recognized risk factor for pancreatic fistula. We conducted this study to clarify if there are preoperative factors related to a soft pancreatic remnant and to establish if they are useful for predicting pancreatic fistula.
Methods
This was a retrospective study of patients who underwent pancreatic resections at the Department of Surgical Sciences of the S. Orsola-Malpighi Hospital, Bologna, Italy. The factors considered were sex, age, co-morbidities, body mass index, American Society of Anesthesiologists score, characteristics of the pancreatic remnant, and preoperative diagnosis.
Results
Data from 208 patients were recorded. The risk factors predictive of a soft pancreatic remnant were BMI >24 kg/m
2
(
P
= 0.011), a Wirsung duct size ≤3 mm (
P
|
doi_str_mv | 10.1007/s00595-014-1045-7 |
format | Article |
fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_1680748111</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>1680748111</sourcerecordid><originalsourceid>FETCH-LOGICAL-c438t-b659923416eb72e6ba6683de61f726d8720361cf8adfe292f56413b2b51bb6dd3</originalsourceid><addsrcrecordid>eNp9kcFO3DAQhi3UqiwLD8Cl8rGXUI_tOMmpWq2grYTUCz1bTjyGrLJxajtI3DjzDPBy-yRkG7bi1Mv4MN__SeOfkHNgF8BY8TUylld5xkBmwGSeFUdkAVKojJcgPpAFqyRkwCs4JicxbhjjsmTsEznmuRDABVuQp1VAmu5wmkNAP2Awqb1H6kyTfIg0YGcSWpo8NXT3-By9S3QwfRPQxN3jCzW9pWZ2POwVtm3-Crw7YKltqGtjGjsTqXEJw_tNwIhTwvffTslHZ7qIZ2_vkvy-urxZ_8iuf33_uV5dZ40UZcpqlVcVFxIU1gVHVRulSmFRgSu4smXBmVDQuNJYh7ziLlcSRM3rHOpaWSuW5MvsHYL_M2JMetvGBrvO9OjHqEGVrJAlAEwozGgTfIwBnR5CuzXhQQPT-wr0XIGeKtD7CnQxZT6_6cd6i_Zf4vDnE8BnIE6r_haD3vgx9NPJ_7G-AtrwlUw</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>1680748111</pqid></control><display><type>article</type><title>Are there preoperative factors related to a “soft pancreas” and are they predictive of pancreatic fistulas after pancreatic resection?</title><source>MEDLINE</source><source>SpringerNature Journals</source><creator>Casadei, Riccardo ; Ricci, Claudio ; Taffurelli, Giovanni ; D’Ambra, Marielda ; Pacilio, Carlo Alberto ; Ingaldi, Carlo ; Minni, Francesco</creator><creatorcontrib>Casadei, Riccardo ; Ricci, Claudio ; Taffurelli, Giovanni ; D’Ambra, Marielda ; Pacilio, Carlo Alberto ; Ingaldi, Carlo ; Minni, Francesco</creatorcontrib><description>Purpose
Soft pancreatic parenchyma is the most widely recognized risk factor for pancreatic fistula. We conducted this study to clarify if there are preoperative factors related to a soft pancreatic remnant and to establish if they are useful for predicting pancreatic fistula.
Methods
This was a retrospective study of patients who underwent pancreatic resections at the Department of Surgical Sciences of the S. Orsola-Malpighi Hospital, Bologna, Italy. The factors considered were sex, age, co-morbidities, body mass index, American Society of Anesthesiologists score, characteristics of the pancreatic remnant, and preoperative diagnosis.
Results
Data from 208 patients were recorded. The risk factors predictive of a soft pancreatic remnant were BMI >24 kg/m
2
(
P
= 0.011), a Wirsung duct size ≤3 mm (
P
< 0.001), and coexisting periampullary diseases (
P
< 0.001). Using these factors, we developed a risk score model that was validated by considering the pancreatic fistula rate. The overall and clinically relevant pancreatic fistula rate increased with increasing score values (
P
= 0.002 and
P
= 0.028, respectively). Using a score cut-off value of six points, patients with a score ≥6 were considered to be at high risk.
Conclusions
Body mass index >24 kg/m
2
, a Wirsung duct size <3 mm, and preoperative diagnosis represented the preoperative factors related to a soft pancreas. These factors proved useful in the building of a risk score model to predict the incidence of pancreatic fistula.</description><identifier>ISSN: 0941-1291</identifier><identifier>EISSN: 1436-2813</identifier><identifier>DOI: 10.1007/s00595-014-1045-7</identifier><identifier>PMID: 25331230</identifier><language>eng</language><publisher>Tokyo: Springer Japan</publisher><subject>Aged ; Body Mass Index ; Female ; Forecasting ; Humans ; Male ; Medicine ; Medicine & Public Health ; Middle Aged ; Original Article ; Pancreas - pathology ; Pancreatectomy ; Pancreatic Ducts - pathology ; Pancreatic Fistula - etiology ; Preoperative Period ; Retrospective Studies ; Risk Factors ; Surgery ; Surgical Oncology</subject><ispartof>Surgery today (Tokyo, Japan), 2015-06, Vol.45 (6), p.708-714</ispartof><rights>Springer Japan 2014</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c438t-b659923416eb72e6ba6683de61f726d8720361cf8adfe292f56413b2b51bb6dd3</citedby><cites>FETCH-LOGICAL-c438t-b659923416eb72e6ba6683de61f726d8720361cf8adfe292f56413b2b51bb6dd3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://link.springer.com/content/pdf/10.1007/s00595-014-1045-7$$EPDF$$P50$$Gspringer$$H</linktopdf><linktohtml>$$Uhttps://link.springer.com/10.1007/s00595-014-1045-7$$EHTML$$P50$$Gspringer$$H</linktohtml><link.rule.ids>314,780,784,27924,27925,41488,42557,51319</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/25331230$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Casadei, Riccardo</creatorcontrib><creatorcontrib>Ricci, Claudio</creatorcontrib><creatorcontrib>Taffurelli, Giovanni</creatorcontrib><creatorcontrib>D’Ambra, Marielda</creatorcontrib><creatorcontrib>Pacilio, Carlo Alberto</creatorcontrib><creatorcontrib>Ingaldi, Carlo</creatorcontrib><creatorcontrib>Minni, Francesco</creatorcontrib><title>Are there preoperative factors related to a “soft pancreas” and are they predictive of pancreatic fistulas after pancreatic resection?</title><title>Surgery today (Tokyo, Japan)</title><addtitle>Surg Today</addtitle><addtitle>Surg Today</addtitle><description>Purpose
Soft pancreatic parenchyma is the most widely recognized risk factor for pancreatic fistula. We conducted this study to clarify if there are preoperative factors related to a soft pancreatic remnant and to establish if they are useful for predicting pancreatic fistula.
Methods
This was a retrospective study of patients who underwent pancreatic resections at the Department of Surgical Sciences of the S. Orsola-Malpighi Hospital, Bologna, Italy. The factors considered were sex, age, co-morbidities, body mass index, American Society of Anesthesiologists score, characteristics of the pancreatic remnant, and preoperative diagnosis.
Results
Data from 208 patients were recorded. The risk factors predictive of a soft pancreatic remnant were BMI >24 kg/m
2
(
P
= 0.011), a Wirsung duct size ≤3 mm (
P
< 0.001), and coexisting periampullary diseases (
P
< 0.001). Using these factors, we developed a risk score model that was validated by considering the pancreatic fistula rate. The overall and clinically relevant pancreatic fistula rate increased with increasing score values (
P
= 0.002 and
P
= 0.028, respectively). Using a score cut-off value of six points, patients with a score ≥6 were considered to be at high risk.
Conclusions
Body mass index >24 kg/m
2
, a Wirsung duct size <3 mm, and preoperative diagnosis represented the preoperative factors related to a soft pancreas. These factors proved useful in the building of a risk score model to predict the incidence of pancreatic fistula.</description><subject>Aged</subject><subject>Body Mass Index</subject><subject>Female</subject><subject>Forecasting</subject><subject>Humans</subject><subject>Male</subject><subject>Medicine</subject><subject>Medicine & Public Health</subject><subject>Middle Aged</subject><subject>Original Article</subject><subject>Pancreas - pathology</subject><subject>Pancreatectomy</subject><subject>Pancreatic Ducts - pathology</subject><subject>Pancreatic Fistula - etiology</subject><subject>Preoperative Period</subject><subject>Retrospective Studies</subject><subject>Risk Factors</subject><subject>Surgery</subject><subject>Surgical Oncology</subject><issn>0941-1291</issn><issn>1436-2813</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2015</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNp9kcFO3DAQhi3UqiwLD8Cl8rGXUI_tOMmpWq2grYTUCz1bTjyGrLJxajtI3DjzDPBy-yRkG7bi1Mv4MN__SeOfkHNgF8BY8TUylld5xkBmwGSeFUdkAVKojJcgPpAFqyRkwCs4JicxbhjjsmTsEznmuRDABVuQp1VAmu5wmkNAP2Awqb1H6kyTfIg0YGcSWpo8NXT3-By9S3QwfRPQxN3jCzW9pWZ2POwVtm3-Crw7YKltqGtjGjsTqXEJw_tNwIhTwvffTslHZ7qIZ2_vkvy-urxZ_8iuf33_uV5dZ40UZcpqlVcVFxIU1gVHVRulSmFRgSu4smXBmVDQuNJYh7ziLlcSRM3rHOpaWSuW5MvsHYL_M2JMetvGBrvO9OjHqEGVrJAlAEwozGgTfIwBnR5CuzXhQQPT-wr0XIGeKtD7CnQxZT6_6cd6i_Zf4vDnE8BnIE6r_haD3vgx9NPJ_7G-AtrwlUw</recordid><startdate>20150601</startdate><enddate>20150601</enddate><creator>Casadei, Riccardo</creator><creator>Ricci, Claudio</creator><creator>Taffurelli, Giovanni</creator><creator>D’Ambra, Marielda</creator><creator>Pacilio, Carlo Alberto</creator><creator>Ingaldi, Carlo</creator><creator>Minni, Francesco</creator><general>Springer Japan</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope></search><sort><creationdate>20150601</creationdate><title>Are there preoperative factors related to a “soft pancreas” and are they predictive of pancreatic fistulas after pancreatic resection?</title><author>Casadei, Riccardo ; Ricci, Claudio ; Taffurelli, Giovanni ; D’Ambra, Marielda ; Pacilio, Carlo Alberto ; Ingaldi, Carlo ; Minni, Francesco</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c438t-b659923416eb72e6ba6683de61f726d8720361cf8adfe292f56413b2b51bb6dd3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2015</creationdate><topic>Aged</topic><topic>Body Mass Index</topic><topic>Female</topic><topic>Forecasting</topic><topic>Humans</topic><topic>Male</topic><topic>Medicine</topic><topic>Medicine & Public Health</topic><topic>Middle Aged</topic><topic>Original Article</topic><topic>Pancreas - pathology</topic><topic>Pancreatectomy</topic><topic>Pancreatic Ducts - pathology</topic><topic>Pancreatic Fistula - etiology</topic><topic>Preoperative Period</topic><topic>Retrospective Studies</topic><topic>Risk Factors</topic><topic>Surgery</topic><topic>Surgical Oncology</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Casadei, Riccardo</creatorcontrib><creatorcontrib>Ricci, Claudio</creatorcontrib><creatorcontrib>Taffurelli, Giovanni</creatorcontrib><creatorcontrib>D’Ambra, Marielda</creatorcontrib><creatorcontrib>Pacilio, Carlo Alberto</creatorcontrib><creatorcontrib>Ingaldi, Carlo</creatorcontrib><creatorcontrib>Minni, Francesco</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>Surgery today (Tokyo, Japan)</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Casadei, Riccardo</au><au>Ricci, Claudio</au><au>Taffurelli, Giovanni</au><au>D’Ambra, Marielda</au><au>Pacilio, Carlo Alberto</au><au>Ingaldi, Carlo</au><au>Minni, Francesco</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Are there preoperative factors related to a “soft pancreas” and are they predictive of pancreatic fistulas after pancreatic resection?</atitle><jtitle>Surgery today (Tokyo, Japan)</jtitle><stitle>Surg Today</stitle><addtitle>Surg Today</addtitle><date>2015-06-01</date><risdate>2015</risdate><volume>45</volume><issue>6</issue><spage>708</spage><epage>714</epage><pages>708-714</pages><issn>0941-1291</issn><eissn>1436-2813</eissn><abstract>Purpose
Soft pancreatic parenchyma is the most widely recognized risk factor for pancreatic fistula. We conducted this study to clarify if there are preoperative factors related to a soft pancreatic remnant and to establish if they are useful for predicting pancreatic fistula.
Methods
This was a retrospective study of patients who underwent pancreatic resections at the Department of Surgical Sciences of the S. Orsola-Malpighi Hospital, Bologna, Italy. The factors considered were sex, age, co-morbidities, body mass index, American Society of Anesthesiologists score, characteristics of the pancreatic remnant, and preoperative diagnosis.
Results
Data from 208 patients were recorded. The risk factors predictive of a soft pancreatic remnant were BMI >24 kg/m
2
(
P
= 0.011), a Wirsung duct size ≤3 mm (
P
< 0.001), and coexisting periampullary diseases (
P
< 0.001). Using these factors, we developed a risk score model that was validated by considering the pancreatic fistula rate. The overall and clinically relevant pancreatic fistula rate increased with increasing score values (
P
= 0.002 and
P
= 0.028, respectively). Using a score cut-off value of six points, patients with a score ≥6 were considered to be at high risk.
Conclusions
Body mass index >24 kg/m
2
, a Wirsung duct size <3 mm, and preoperative diagnosis represented the preoperative factors related to a soft pancreas. These factors proved useful in the building of a risk score model to predict the incidence of pancreatic fistula.</abstract><cop>Tokyo</cop><pub>Springer Japan</pub><pmid>25331230</pmid><doi>10.1007/s00595-014-1045-7</doi><tpages>7</tpages></addata></record> |
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language | eng |
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source | MEDLINE; SpringerNature Journals |
subjects | Aged Body Mass Index Female Forecasting Humans Male Medicine Medicine & Public Health Middle Aged Original Article Pancreas - pathology Pancreatectomy Pancreatic Ducts - pathology Pancreatic Fistula - etiology Preoperative Period Retrospective Studies Risk Factors Surgery Surgical Oncology |
title | Are there preoperative factors related to a “soft pancreas” and are they predictive of pancreatic fistulas after pancreatic resection? |
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