The usefulness of a grading system for complications resulting from pancreatic resections: A single center experience

被引:11
作者
Casadei R. [1 ]
Ricci C. [1 ]
Pezzilli R. [2 ]
Morselli-Labate A.M. [2 ]
Calculli L. [3 ]
D'Ambra M. [1 ]
Monari F. [1 ]
Taffurelli G. [1 ]
Minni F. [1 ]
机构
[1] Dipartimento di Scienze Chirurgiche e Anestesiologiche, Chirurgia Generale-Minni, Università di Bologna, 40138 Bologna
[2] Dipartimento di Malattie Dell'Apparato Digerente e Medicina Interna, Alma Mater Studiorum, Università di Bologna, Bologna
[3] Dipartimento di Scienze Radiologiche e Istocitopatologiche, Alma Mater Studiorum, Università di Bologna, Bologna
关键词
Pancreatic neoplasm; Postoperative complications; Surgery;
D O I
10.1007/s13304-011-0073-8
中图分类号
学科分类号
摘要
The aim of this study was to test the usefulness of the Clavien-Dindo classification after pancreatic resection. In 183 patients who underwent pancreatic resections, complications were classified according to Clavien-Dindo classification and each grade was evaluated regarding the length of the postoperative stay and was compared to the most important complications. Sixty-four (35.0%) patients had no complications; out of the 119 (65.0%) patients with complications, grade I, was 9.3%; grade II, 35.5%; grade III, 9.3%; grade IV, 7.7% and grade V, 3.3%. The postoperative pancreatic fistula rate was 29.1%, postpancreatectomy hemorrhage, 35% and delayed gastric emptying, 11.5%. There was a progressive increase in the length of hospitalization from patients with no complications to those having grade IV (P0.001). Postoperative pancreatic fistula, postpancreatectomy hemorrhage and delayed gastric empty rates significantly increased from Clavien-Dindo grade I to grade IV; only postoperative pancreatic fistula and postpancreatectomy hemorrhage severity significantly increased from grade I to grade IV (both P0.001). The Clavien-Dindo classification is an objective, simple, and reliable way of reporting all complications following pancreatic resections and it allows to recognize appropriately all the most important complications after pancreatic resection, and the severity of postoperative pancreatic fistula and postpancreatectomy hemorrhage. © 2011 Springer-Verlag.
引用
收藏
页码:97 / 102
页数:5
相关论文
共 10 条
  • [1] Simons J.P., Shah S.A., Ng S.C., Et al., National complication rates after pancreatectomy: Beyond mere mortality, J Gastrointest Surg, 13, pp. 1798-1805, (2009)
  • [2] Yoshioka R., Saiura A., Koga R., Et al., Risk factors for clinical pancreatic fistula after distal pancreatectomy: Analysis of consecutive 100 patients, World J Surg, 34, pp. 121-125, (2010)
  • [3] Bassi C., Dervenis C., Butturini G., Fingerhut A., Yeo C., Izbicki J., Neoptolemos J., Sarr M., Traverso W., Buchler M., Postoperative pancreatic fistula: An international study group (ISGPF) definition, Surgery, 138, 1, pp. 8-13, (2005)
  • [4] Wente M.N., Veit J.A., Bassi C., Dervenis C., Fingerhut A., Gouma D.J., Izbicki J.R., Neoptolemos J.P., Padbury R.T., Sarr M.G., Yeo C.J., Buchler M.W., Postpancreatectomy hemorrhage (PPH)-An International Study Group of Pancreatic Surgery (ISGPS) definition, Surgery, 142, 1, pp. 20-25, (2007)
  • [5] Wente M.N., Bassi C., Dervenis C., Fingerhut A., Gouma D.J., Izbicki J.R., Neoptolemos J.P., Padbury R.T., Sarr M.G., Traverso L.W., Yeo C.J., Buchler M.W., Delayed gastric emptying (DGE) after pancreatic surgery: A suggested definition by the International Study Group of Pancreatic Surgery (ISGPS), Surgery, 142, 5, pp. 761-768, (2007)
  • [6] Clavien P.A., Sanabria J.R., Strasberg S.M., Proposed classification of complications of surgery with examples of utility in cholecystectomy, Surgery, 111, pp. 518-526, (1992)
  • [7] Dindo D., Demartines N., Clavien P.-A., Classification of surgical complications: A new proposal with evaluation in a cohort of 6336 patients and results of a survey, Annals of Surgery, 240, 2, pp. 205-213, (2004)
  • [8] De Oliveira M.L., Winter J.M., Schaffer M., Et al., Assessment of complications after pancreatic surgery. A novel grading system applied to 633 patients undergoing pancreaticoduodenectomy, Ann Surg, 244, pp. 931-939, (2006)
  • [9] Clavien P.A., Barkun J., De Oliveira M.L., Et al., The Clavien-Dindo classification of surgical complications: Five-year experience, Ann Surg, 250, pp. 187-196, (2009)
  • [10] Rangelova E., Permert J., Ansorge C., Et al., Evaluation of a complications grading system for pancreatic surgery, Pancreas, 37, (2008)