Preoperative anthropomorphic and nutritious status and fistula risk score for predicting clinically relevant postoperative pancreatic fistula after pancreaticoduodenectomy

被引:11
作者
Abe, Tomoyuki [1 ]
Amano, Hironobu [1 ,2 ]
Kobayashi, Tsuyoshi [2 ]
Hanada, Keiji [3 ]
Hattori, Minoru [4 ]
Nakahara, Masahiro [1 ]
Ohdan, Hideki [2 ]
Noriyuki, Toshio [1 ,2 ]
机构
[1] Onomichi Gen Hosp, Dept Surg, 1-10-23 Onomichi, Hiroshima 7228508, Japan
[2] Hiroshima Univ, Grad Sch Biomed & Hlth Sci, Dept Gastroenterol & Transplant Surg, Hiroshima, Japan
[3] Onomichi Gen Hosp, Dept Gastroenterol, Hiroshima, Japan
[4] Hiroshima Univ, Adv Med Skills Training Ctr, Inst Biomed & Hlth Sci, Hiroshima, Japan
关键词
Fistula risk score; Pancreaticoduodenectomy; Postoperative pancreatic fistula; Skeletal muscle index; Visceral adipose tissue area; SARCOPENIA; COMPLICATIONS; OBESITY; MORTALITY; CACHEXIA; IMPACT; INDEX;
D O I
10.1186/s12876-020-01397-7
中图分类号
R57 [消化系及腹部疾病];
学科分类号
摘要
Background Postoperative pancreatic fistula (POPF) is a life-threatening postoperative complication. The aim of this study was to evaluate the efficacy of the fistula risk score (FRS) and preoperative body composition factors for predicting the occurrence of clinically relevant POPF (CR-POPF) after pancreaticoduodenectomy (PD). Methods In this study, 136 consecutive patients who underwent PD between 2006 and 2018 were enrolled. The risk factors of CR-POPF (grades B and C) were analyzed. Preoperative visceral adipose tissue area (VATA), skeletal mass index (SMI), and subcutaneous adipose tissue area (SATA) were calculated from computed tomography data. Results The overall 30-day mortality and morbidity rates were 0.7 and 38%, respectively. The incidence rates of grade B and C CR-POPF were 27 and 4%, respectively. A univariate analysis revealed that male sex, habitual smoking, prognostic nutritional index (PNI) < 45, VATA >= 90, VATA/SATA >= 0.9, VATA/SMI >= 1.4, and FRS > 4 were significantly associated with the incidence of CR-POPF. A multivariate analysis revealed that PNI < 45, VATA/SMI >= 1.4 and FRS > 4 were the independent risk factors of CR-POPF. Conclusions Preoperative anthropomorphic imbalance, PNI, and FRS were independent risk factors for CR-POPF. Patients with high-risk factors should be closely monitored during the postoperative period.
引用
收藏
页数:6
相关论文
共 22 条
  • [1] Risk factors of serious postoperative complications after pancreaticoduodenectomy and risk calculators for predicting postoperative complications: a nationwide study of 17,564 patients in Japan
    Aoki, Shuichi
    Miyata, Hiroaki
    Konno, Hiroyuki
    Gotoh, Mitsukazu
    Motoi, Fuyuhiko
    Kumamaru, Hiraku
    Wakabayashi, Go
    Kakeji, Yoshihiro
    Mori, Masaki
    Seto, Yasuyuki
    Unno, Michiaki
    [J]. JOURNAL OF HEPATO-BILIARY-PANCREATIC SCIENCES, 2017, 24 (05) : 243 - 251
  • [2] Cachexia and sarcopenia: mechanisms and potential targets for intervention
    Argiles, Josep M.
    Busquets, Silvia
    Stemmler, Britta
    Lopez-Soriano, Francisco J.
    [J]. CURRENT OPINION IN PHARMACOLOGY, 2015, 22 : 100 - 106
  • [3] Postoperative pancreatic fistula: An international study group (ISGPF) definition
    Bassi, C
    Dervenis, C
    Butturini, G
    Fingerhut, A
    Yeo, C
    Izbicki, J
    Neoptolemos, J
    Sarr, M
    Traverso, W
    Buchler, M
    [J]. SURGERY, 2005, 138 (01) : 8 - 13
  • [4] Epidemiology of sarcopenia among the elderly in New Mexico
    Baumgartner, RN
    Koehler, KM
    Gallagher, D
    Romero, L
    Heymsfield, SB
    Ross, RR
    Garry, PJ
    Lindeman, RD
    [J]. AMERICAN JOURNAL OF EPIDEMIOLOGY, 1998, 147 (08) : 755 - 763
  • [5] A Prospectively Validated Clinical Risk Score Accurately Predicts Pancreatic Fistula after Pancreatoduodenectomy
    Callery, Mark P.
    Pratt, Wande B.
    Kent, Tara S.
    Chaikof, Elliot L.
    Vollmer, Charles M., Jr.
    [J]. JOURNAL OF THE AMERICAN COLLEGE OF SURGEONS, 2013, 216 (01) : 1 - 14
  • [6] Obesity in general elective surgery
    Dindo, D
    Muller, MK
    Weber, M
    Clavien, PA
    [J]. LANCET, 2003, 361 (9374) : 2032 - 2035
  • [7] Life-threatening postoperative pancreatic fistula (grade C) after pancreaticoduodenectomy: incidence, prognosis, and risk factors
    Fuks, David
    Piessen, Guillaume
    Huet, Emmanuel
    Tavernier, Marion
    Zerbib, Philippe
    Michot, Francis
    Scotte, Michel
    Triboulet, Jean-Pierre
    Mariette, Christophe
    Chiche, Laurence
    Salame, Ephraim
    Segol, Philippe
    Pruvot, Francois-Rene
    Mauvais, Francois
    Roman, Horace
    Verhaeghe, Pierre
    Regimbeau, Jean-Marc
    [J]. AMERICAN JOURNAL OF SURGERY, 2009, 197 (06) : 702 - 709
  • [8] Fatty pancreas and increased body mass index are risk factors of pancreatic fistula after pancreaticoduodenectomy
    Gaujoux, Sebastien
    Cortes, Alexandre
    Couvelard, Anne
    Noullet, Severine
    Clavel, Laurent
    Rebours, Vinciane
    Levy, Philippe
    Sauvanet, Alain
    Ruszniewski, Philippe
    Belghiti, Jacques
    [J]. SURGERY, 2010, 148 (01) : 15 - 23
  • [9] Preoperative predictors for complications after pancreaticoduodenectomy: Impact of BMI and body fat distribution
    House, Michael G.
    Fong, Yuman
    Arnaoutakis, Dean J.
    Sharma, Rohit
    Winston, Corinne B.
    Protic, Mladjan
    Gonen, Mithat
    Olson, Sara H.
    Kurtz, Robert C.
    Brennan, Murray F.
    Allen, Peter J.
    [J]. JOURNAL OF GASTROINTESTINAL SURGERY, 2008, 12 (02) : 270 - 278
  • [10] Impact of Sarcopenia on Survival in Patients Undergoing Living Donor Liver Transplantation
    Kaido, T.
    Ogawa, K.
    Fujimoto, Y.
    Ogura, Y.
    Hata, K.
    Ito, T.
    Tomiyama, K.
    Yagi, S.
    Mori, A.
    Uemoto, S.
    [J]. AMERICAN JOURNAL OF TRANSPLANTATION, 2013, 13 (06) : 1549 - 1556