Risk factors for pancreas-related abscess after total gastrectomy

Hitoshi Katai, Kimio Yoshimura, Takeo Fukagawa, Takeshi Sano, Mitsuru Sasako

研究成果: Article

33 引用 (Scopus)

抄録

Background. European clinical trials of gastrectomy have shown that pancreas-related complications are the major cause of mortality. The aim of this study was to determine the risk factors for pancreas-related abscess after gastrectomy and to evaluate the effects of the abscess on postoperative mortality. Methods. Between 1992 and 1999, 663 consecutive patients with gastric carcinoma underwent total gastrectomy. Data from these patients were analyzed, to identify the predictors of pancreas-related abscess caused by pancreatic juice leakage, by a multiple logistic regression model. Results. On multivariate analysis, increasing age (P = 0.018) and body mass index (P = 0.006) were independent preoperative risk factors. Dissection along the distal splenic artery was an intraoperative risk factor. The hazard ratios were increased 9.13-fold (P = 0.000) with a pancreas-preserving operation and 16.72-fold (P = 0.000) by distal pancreatectomy. Patients with the abscess had a higher postoperative mortality rate (P = 0.008), and a higher re-operation rate (P < 0.001) than patients without the abscess. Conclusion. Pancreas-related abscess is more likely to occur in older, obese patients undergoing node dissection along the distal splenic artery. Abscess formation is associated with a higher mortality and re-operation rate. Spleen preservation should be evaluated in Japan.

元の言語English
ページ(範囲)137-141
ページ数5
ジャーナルGastric Cancer
8
発行部数3
DOI
出版物ステータスPublished - 2005 8
外部発表Yes

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Gastrectomy
Abscess
Pancreas
Splenic Artery
Mortality
Dissection
Logistic Models
Pancreatic Juice
Pancreatectomy
Stomach
Japan
Body Mass Index
Spleen
Multivariate Analysis
Clinical Trials
Carcinoma

ASJC Scopus subject areas

  • Oncology
  • Gastroenterology
  • Cancer Research

これを引用

Risk factors for pancreas-related abscess after total gastrectomy. / Katai, Hitoshi; Yoshimura, Kimio; Fukagawa, Takeo; Sano, Takeshi; Sasako, Mitsuru.

:: Gastric Cancer, 巻 8, 番号 3, 08.2005, p. 137-141.

研究成果: Article

Katai, Hitoshi ; Yoshimura, Kimio ; Fukagawa, Takeo ; Sano, Takeshi ; Sasako, Mitsuru. / Risk factors for pancreas-related abscess after total gastrectomy. :: Gastric Cancer. 2005 ; 巻 8, 番号 3. pp. 137-141.
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N2 - Background. European clinical trials of gastrectomy have shown that pancreas-related complications are the major cause of mortality. The aim of this study was to determine the risk factors for pancreas-related abscess after gastrectomy and to evaluate the effects of the abscess on postoperative mortality. Methods. Between 1992 and 1999, 663 consecutive patients with gastric carcinoma underwent total gastrectomy. Data from these patients were analyzed, to identify the predictors of pancreas-related abscess caused by pancreatic juice leakage, by a multiple logistic regression model. Results. On multivariate analysis, increasing age (P = 0.018) and body mass index (P = 0.006) were independent preoperative risk factors. Dissection along the distal splenic artery was an intraoperative risk factor. The hazard ratios were increased 9.13-fold (P = 0.000) with a pancreas-preserving operation and 16.72-fold (P = 0.000) by distal pancreatectomy. Patients with the abscess had a higher postoperative mortality rate (P = 0.008), and a higher re-operation rate (P < 0.001) than patients without the abscess. Conclusion. Pancreas-related abscess is more likely to occur in older, obese patients undergoing node dissection along the distal splenic artery. Abscess formation is associated with a higher mortality and re-operation rate. Spleen preservation should be evaluated in Japan.

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