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Fistula risk score-adjusted comparison of postoperative pancreatic fistula following laparoscopic vs open pancreatoduodenectomy

Authors
 Boram Lee  ;  Yoo-Seok Yoon  ;  Chang Moo Kang  ;  Munseok Choi  ;  Jun Suh Lee  ;  Ho Kyoung Hwang  ;  Jai Young Cho  ;  Woo Jung Lee  ;  Ho-Seong Han 
Citation
 JOURNAL OF HEPATO-BILIARY-PANCREATIC SCIENCES, Vol.28(12) : 1089-1097, 2021-12 
Journal Title
JOURNAL OF HEPATO-BILIARY-PANCREATIC SCIENCES
ISSN
 1868-6974 
Issue Date
2021-12
MeSH
Humans ; Laparoscopy* / adverse effects ; Pancreas / surgery ; Pancreatic Fistula* / epidemiology ; Pancreatic Fistula* / etiology ; Pancreatic Fistula* / surgery ; Pancreaticoduodenectomy / adverse effects ; Postoperative Complications / epidemiology ; Retrospective Studies ; Risk Factors
Keywords
laparoscopy ; pancreatic fistula ; pancreaticoduodenectomy ; risk-adjusted analysis
Abstract
Background: To evaluate a risk-adjusted comparison of clinically relevant postoperative pancreatic fistula POPF (CR-POPF) following laparoscopic pancreatoduodenectomy (LPD) vs open pancreatoduodenectomy (OPD) using the fistula risk score (FRS).

Methods: We retrospectively analyzed 579 patients who underwent LPD (n = 274) or OPD (n = 305) between 2012 and 2019 at two tertiary hospitals. Using the FRS, the risk was stratified into four categories; negligible, low, intermediate and high risk.

Results: The median FRS was significantly higher in the LPD than in the OPD group (5.4 ± 1.2 vs 3.9 ± 1.8, P < .001). The overall incidence of CR-POPF in the LPD vs OPD groups were 16.4% vs 17.7% (P = .187). When POPF risks were stratified by FRS, CR-POPF following LPD vs OPD in patients with low risk (0% vs 6.3%, P = .294), intermediate risk (16.1% vs 22.9%, P = .053) and high risk (33.3% vs 27.3%, P = .577) were not significantly different.

Conclusion: Despite a higher risk score in the LPD group, the CR-POPF was similar following both procedures in the unadjusted and FRS-risk-adjusted comparisons. The CR-POPF was more significantly affected by patient risk factors such as the soft pancreas and small pancreatic duct.
Full Text
https://onlinelibrary.wiley.com/doi/10.1002/jhbp.866
DOI
10.1002/jhbp.866
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Surgery (외과학교실) > 1. Journal Papers
Yonsei Authors
Kang, Chang Moo(강창무) ORCID logo https://orcid.org/0000-0002-5382-4658
Lee, Woo Jung(이우정) ORCID logo https://orcid.org/0000-0001-9273-261X
Choi, Munseok(최문석) ORCID logo https://orcid.org/0000-0002-9844-4747
Hwang, Ho Kyoung(황호경) ORCID logo https://orcid.org/0000-0003-4064-7776
URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/188176
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