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
Hauptverfasser: Casadei, Riccardo, Ricci, Claudio, Taffurelli, Giovanni, D’Ambra, Marielda, Pacilio, Carlo Alberto, Ingaldi, Carlo, Minni, Francesco
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container_end_page 714
container_issue 6
container_start_page 708
container_title Surgery today (Tokyo, Japan)
container_volume 45
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
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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 &gt;24 kg/m 2 ( P  = 0.011), a Wirsung duct size ≤3 mm ( P  &lt; 0.001), and coexisting periampullary diseases ( P  &lt; 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 &gt;24 kg/m 2 , a Wirsung duct size &lt;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 &amp; 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 &gt;24 kg/m 2 ( P  = 0.011), a Wirsung duct size ≤3 mm ( P  &lt; 0.001), and coexisting periampullary diseases ( P  &lt; 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 &gt;24 kg/m 2 , a Wirsung duct size &lt;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 &amp; 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 &amp; 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 &gt;24 kg/m 2 ( P  = 0.011), a Wirsung duct size ≤3 mm ( P  &lt; 0.001), and coexisting periampullary diseases ( P  &lt; 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 &gt;24 kg/m 2 , a Wirsung duct size &lt;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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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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