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.

Casadei, R., Ricci, C., Taffurelli, G., D'Ambra, M., Pacilio, C.a., Ingaldi, C., et al. (2015). Pancreatic resections: are there preoperative factors related to a "soft pancreas" and are they useful in predicting pancreatic fistulas?. SURGERY TODAY, 45(6), 708-714 [10.1007/s00595-014-1045-7].

Pancreatic resections: are there preoperative factors related to a "soft pancreas" and are they useful in predicting pancreatic fistulas?

CASADEI, RICCARDO;RICCI, CLAUDIO;TAFFURELLI, GIOVANNI;D'AMBRA, MARIELDA;PACILIO, CARLO ALBERTO;MINNI, FRANCESCO
2015

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.
2015
Casadei, R., Ricci, C., Taffurelli, G., D'Ambra, M., Pacilio, C.a., Ingaldi, C., et al. (2015). Pancreatic resections: are there preoperative factors related to a "soft pancreas" and are they useful in predicting pancreatic fistulas?. SURGERY TODAY, 45(6), 708-714 [10.1007/s00595-014-1045-7].
Casadei, R; Ricci, C; Taffurelli, G; D'Ambra, M; Pacilio, Ca; Ingaldi, C; Minni, F.
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Utilizza questo identificativo per citare o creare un link a questo documento: https://hdl.handle.net/11585/263409
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