Abstract
Background: The morbidity rate after pancreaticoduodenectomy remains high. The objectives of this retrospective cohort study were to clarify the risk factors associated with serious morbidity (Clavien-Dindo classification grades IV-V), and create complication risk calculators using the Japanese National Clinical Database. Methods: Between 2011 and 2012, data from 17,564 patients who underwent pancreaticoduodenectomy at 1,311 institutions in Japan were recorded in this database. The morbidity rate and associated risk factors were analyzed. Results: The overall and serious morbidity rates were 41.6% and 4.5%, respectively. A pancreatic fistula (PF) with an International Study Group of Pancreatic Fistula (ISGPF) grade C was significantly associated with serious morbidity (P < 0.001). Twenty-one variables were considered statistically significant predictors of serious complications, and 15 of them overlapped with those of a PF with ISGPF grade C. The predictors included age, sex, obesity, functional status, smoking status, the presence of a comorbidity, non-pancreatic cancer, combined vascular resection, and several abnormal laboratory results. C-indices of the risk models for serious morbidity and grade C PF were 0.708 and 0.700, respectively. Conclusions: Preventing a PF grade C is important for decreasing the serious morbidity rate and these risk calculations contribute to adequate patient selection.
| Original language | English |
|---|---|
| Journal | Journal of Hepato-Biliary-Pancreatic Sciences |
| DOIs | |
| Publication status | Accepted/In press - 2017 |
| Externally published | Yes |
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Keywords
- Pancreaticoduodenectomy
- Postoperative complications
- Risk calculator
ASJC Scopus subject areas
- Surgery
- Hepatology
Cite this
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.
In: Journal of Hepato-Biliary-Pancreatic Sciences, 2017.Research output: Contribution to journal › Article
}
TY - JOUR
T1 - Risk factors of serious postoperative complications after pancreaticoduodenectomy and risk calculators for predicting postoperative complications
T2 - A nationwide study of 17,564 patients in Japan
AU - Aoki, Shuichi
AU - Miyata, Hiroaki
AU - Konno, Hiroyuki
AU - Gotoh, Mitsukazu
AU - Motoi, Fuyuhiko
AU - Kumamaru, Hiraku
AU - Wakabayashi, Go
AU - Kakeji, Yoshihiro
AU - Mori, Masaki
AU - Seto, Yasuyuki
AU - Unno, Michiaki
PY - 2017
Y1 - 2017
N2 - Background: The morbidity rate after pancreaticoduodenectomy remains high. The objectives of this retrospective cohort study were to clarify the risk factors associated with serious morbidity (Clavien-Dindo classification grades IV-V), and create complication risk calculators using the Japanese National Clinical Database. Methods: Between 2011 and 2012, data from 17,564 patients who underwent pancreaticoduodenectomy at 1,311 institutions in Japan were recorded in this database. The morbidity rate and associated risk factors were analyzed. Results: The overall and serious morbidity rates were 41.6% and 4.5%, respectively. A pancreatic fistula (PF) with an International Study Group of Pancreatic Fistula (ISGPF) grade C was significantly associated with serious morbidity (P < 0.001). Twenty-one variables were considered statistically significant predictors of serious complications, and 15 of them overlapped with those of a PF with ISGPF grade C. The predictors included age, sex, obesity, functional status, smoking status, the presence of a comorbidity, non-pancreatic cancer, combined vascular resection, and several abnormal laboratory results. C-indices of the risk models for serious morbidity and grade C PF were 0.708 and 0.700, respectively. Conclusions: Preventing a PF grade C is important for decreasing the serious morbidity rate and these risk calculations contribute to adequate patient selection.
AB - Background: The morbidity rate after pancreaticoduodenectomy remains high. The objectives of this retrospective cohort study were to clarify the risk factors associated with serious morbidity (Clavien-Dindo classification grades IV-V), and create complication risk calculators using the Japanese National Clinical Database. Methods: Between 2011 and 2012, data from 17,564 patients who underwent pancreaticoduodenectomy at 1,311 institutions in Japan were recorded in this database. The morbidity rate and associated risk factors were analyzed. Results: The overall and serious morbidity rates were 41.6% and 4.5%, respectively. A pancreatic fistula (PF) with an International Study Group of Pancreatic Fistula (ISGPF) grade C was significantly associated with serious morbidity (P < 0.001). Twenty-one variables were considered statistically significant predictors of serious complications, and 15 of them overlapped with those of a PF with ISGPF grade C. The predictors included age, sex, obesity, functional status, smoking status, the presence of a comorbidity, non-pancreatic cancer, combined vascular resection, and several abnormal laboratory results. C-indices of the risk models for serious morbidity and grade C PF were 0.708 and 0.700, respectively. Conclusions: Preventing a PF grade C is important for decreasing the serious morbidity rate and these risk calculations contribute to adequate patient selection.
KW - Pancreaticoduodenectomy
KW - Postoperative complications
KW - Risk calculator
UR - http://www.scopus.com/inward/record.url?scp=85017238887&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=85017238887&partnerID=8YFLogxK
U2 - 10.1002/jhbp.438
DO - 10.1002/jhbp.438
M3 - Article
C2 - 28196308
AN - SCOPUS:85017238887
JO - Journal of Hepato-Biliary-Pancreatic Sciences
JF - Journal of Hepato-Biliary-Pancreatic Sciences
SN - 1868-6974
ER -