Late postpancreatectomy hemorrhage after pancreaticoduodenectomy: is it possible to recognize risk factors?

Salvatore Buscemi, Claudio Ricci, Francesco Minni, Riccardo Casadei, Salvatore Buscemi

Risultato della ricerca: Articlepeer review

23 Citazioni (Scopus)

Abstract

CONTEXT: Post-pancreatectomy hemorrhage is one of the most common complications after pancreaticoduodenectomy.OBJECTIVE: To evaluate the late post-pancreatectomy hemorrhage rate according to the International Study Group of Pancreatic Surgery criteria and to recognize factors related to its onset.METHODS: A prospective study of 113 patients who underwent pancreaticoduodenectomy was conducted. Late post-pancreatectomy hemorrhage was defined according to the criteria of the International Study Group of Pancreatic Surgery. Demographic, clinical, surgical and pathological data were considered and related to late post-pancreatectomy hemorrhage.RESULTS: Thirty-one (27.4%) patients had a post-pancreatectomy hemorrhage. Twenty-five (22.1%) patients developed late post-pancreatectomy hemorrhage: 19 (16.8%) grade B, 6 (5.3%) grade C. Surgical re-operation was performed in 2 out of the 25 cases with late post-pancreatectomy hemorrhage (8.0%) grade C associated with postoperative pancreatic fistula. At univariate analysis, the only factor significantly related to late post-pancreatectomy hemorrhage was postoperative pancreatic fistula (P<0.001). Multivariate analysis underlined that the severity of postoperative pancreatic fistula (P<0.001) and pancreatic anastomosis (P=0.049) independently increased the risk of late hemorrhage.CONCLUSION: In patients undergoing pancreaticoduodenectomy, the criteria introduced by International Study Group of Pancreatic Surgery to define late postpancreatectomy hemorrhage are related to a higher incidence of hemorrhage than previously detected because they considered also mild hemorrhage.
Lingua originaleEnglish
pagine (da-a)193-198
Numero di pagine6
RivistaJOP. JOURNAL OF THE PANCREAS
Volume13
Stato di pubblicazionePublished - 2012

All Science Journal Classification (ASJC) codes

  • Endocrinology, Diabetes and Metabolism
  • Hepatology
  • Endocrinology

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