Analysis of predictors for postoperative complications after pancreatectomy–what is new after establishing the definition of postpancreatectomy acute pancreatitis (PPAP)?

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Contributors

Abstract

Purpose: We aimed to analyze the predictive value of hyperamylasemia after pancreatectomy for morbidity and for the decision to perform rescue completion pancreatectomy (CP) in a retrospective cohort study. Methods: Data were extracted from a retrospective clinical database. Postoperative hyperamylasemia (POH) and postoperative hyperlipasemia (POHL) were defined by values greater than those accepted as the upper limit at our institution on postoperative day 1 (POD1). The endpoints of the study were the association of POH with postoperative morbidity and the possible predictors for postpancreatectomy acute pancreatitis (PPAP) and severe complications such as the necessity for rescue CP. Results: We analyzed 437 patients who underwent pancreaticoduodenectomy over a period of 7 years. Among them, 219 (52.3%) patients had POH and 200 (47.7%) had normal postoperative amylase (non-POH) levels. A soft pancreatic texture (odds ratio [OR] 3.86) and POH on POD1 (OR 8.2) were independent predictors of postoperative pancreatic fistula (POPF), and POH on POD1 (OR 6.38) was an independent predictor of rescue CP. The clinically relevant POPF (49.5% vs. 11.4%, p < 0.001), intraabdominal abscess (38.3% vs. 15.3%, p < 0.001), postoperative hemorrhage (22.8% vs. 5.1%, p < 0.001), major complications (Clavien-Dindo classification > 2) (52.5% vs. 25.6%, p < 0.001), and CP (13% vs. 1.8%, p < 0.001) occurred significantly more often in the POH group than in the non-POH group. Conclusion: Although POH on POD1 occurs frequently, in addition to other risk factors, it has a predictive value for the development of postoperative morbidity associated with PPAP and CP.

Details

Original languageEnglish
Article number79
Number of pages11
JournalLangenbeck's archives of surgery
Volume408
Issue number1
Publication statusPublished - 6 Feb 2023
Peer-reviewedYes

External IDs

PubMed 36746822
ORCID /0000-0003-3865-095X/work/128183951

Keywords

ASJC Scopus subject areas

Keywords

  • Pancreatic fistula, Pancreaticoduodenectomy, Postoperative hyperamylasemia, Postpancreatectomy pancreatitis, Rescue pancreatectomy

Library keywords