ArticleMedicine2018
Risk factors for postoperative pancreatic fistula: Analysis of 170 consecutive cases of pancreaticoduodenectomy based on the updated ISGPS classification and grading system.
Article in Medicine, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 27 papers, 1 of them a synthesis that pooled it.
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Who cites it
27 citing papers in PubMed, 1 synthesis or guideline pooled it.
- A Simple Classification of Pancreatic Duct Size and Texture Predicts Postoperative Pancreatic Fistula: A classification of the International Study Group of Pancreatic Surgery.Annals of surgery · 2023Pooled it
- Liver perfusion failure after pancreatoduodenectomy: clinical significance and perioperative risk factors.BJS open · 2026Article
- Risk Factors for Postoperative Pancreatic Fistula After Pancreaticoduodenectomy: A Single-Center Experience.Cureus · 2026Article
- Current German practices in the prevention and management of postoperative pancreatic fistula following pancreatoduodenectomy: a nationwide survey.Langenbeck's archives of surgery · 2026Article
- Contemporary Assessment of Post-Operative Pancreatic Fistula After Pancreatoduodenectomy in a European Hepato-Pancreato-Biliary Center: A 5-Year Experience.Medicina (Kaunas, Lithuania) · 2026Article
- Machine learning-based prediction of postoperative pancreatic fistula after laparoscopic pancreaticoduodenectomy.BMC surgery · 2025Article
- RISK FACTORS FOR POSTOPERATIVE PANCREATIC FISTULA FOLLOWING PANCREATICODUODENECTOMY: TUNISIAN CENTER EXPERIENCE.Arquivos brasileiros de cirurgia digestiva : ABCD = Brazilian archives of digestive surgery · 2025Article
- Advancements in postoperative pancreatic fistula: a comprehensive review of predictive factors, therapies, scoring systems and ongoing trials.eGastroenterology · 2025Review
- Article
- Identifying the risk factors for pancreatic fistula after laparoscopic pancreaticoduodenectomy in patients with pancreatic cancer.World journal of gastrointestinal surgery · 2024Article
- Mahamana Technique of Pancreaticogastrostomy: A Safe and Reliable Technique for a Difficult Pancreatic Stump.Cureus · 2024Article
- Postoperative complications after pancreatoduodenectomy for malignancy: results from the Recurrence After Whipple's (RAW) study.BJS open · 2023Article
- Pancreatic Fistulas: Current Evidence and Strategy-A Narrative Review.Journal of clinical medicine · 2023Review
- Endoscopic Transmural Therapy of Pancreatic Fistulas in an Interdisciplinary Setting-A Retrospective Data Analysis.Journal of clinical medicine · 2023Article
- Effects of intraoperative fluid balance during pancreatoduodenectomy on postoperative pancreatic fistula: an observational cohort study.BMC surgery · 2023Observational
- Validation of original, alternative, and updated alternative fistula risk scores after open and minimally invasive pancreatoduodenectomy in an Asian patient cohort.Surgical endoscopy · 2023Article
- Surgical management of pancreatic ductal adenocarcinoma: a narrative review.Translational gastroenterology and hepatology · 2023Review
- Selective use of pancreatic duct occlusion during pancreaticoduodenectomy in patients with a small-size duct and atrophic parenchyma in the distal pancreas: A retrospective study.Frontiers in surgery · 2022Article
- Laparoscopic pancreaticoduodenectomy reduces incidence of clinically relevant postoperative pancreatic fistula in soft pancreas with a smaller than 2 mm pancreatic duct.Surgical endoscopy · 2021Article
- Protective or Risk Factors for Postoperative Pancreatic Fistulas in Malignant Pathology.Life (Basel, Switzerland) · 2021Article
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Authors and funding
10 authors.
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Abstract
This study was designed to analyze the risk factors for postoperative pancreatic fistula (POPF) after pancreaticoduodenectomy (PD).Between September 2015 and August 2017, 170 successive patients underwent a radical PD in the Department of Pancreatic Surgery, Union Hospital, Wuhan. We carried out a retrospective study of these cases and the prospective conditions, which might be related to POPF, were examined with univariate and multivariate analysis. POPF was defined as a drain output of any measurable volume of fluid with an amylase level more than 3 times the upper limit of serum amylase activity on postoperative day 3, accompanied by a clinically relevant condition according to the 2016 update of the International Study Group for Pancreatic Surgery (ISGPS) definition. In our study, the POPF was just referred to as grade B and grade C pancreatic fistula in accordance with the ISGPS consensus, because the former grade A pancreatic fistula is now redefined as a biochemical leak, namely no-POPF, which has no clinical impact and needs no other special therapy.Pancreatic fistula occurred in 44 (25.9%) patients after PD, with a mean length of hospital stay of 24.98 ± 14.30 days. Thirty-six patients (21.2%) developed grade B pancreatic fistula, and 8 patients (4.7%) had grade C pancreatic fistula. Among patients with grade C pancreatic fistula, 4 patients died, 3 patients were operated on again, and 3 patients developed multiple organ failure.Univariate analysis showed a significantly important association between POPF and the following factors: pancreas texture (soft vs hard: 39.1% vs 10.3%, P < .0001) and fasting blood glucose level (<108.0 mg/dL vs ≥108.0 mg/dL: 32.5% vs 12.5%, P = .005). Multivariate logistic regression analysis identified 2 independent factors related to POPF: soft pancreas texture and fasting blood glucose level <108.0 mg/dL.A soft pancreas and a fasting blood glucose level of <108.0 mg/dL are risk factors for the development of a POPF.
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