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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.
SUBMITTER: Aoki S
PROVIDER: S-EPMC5516144 | biostudies-literature | 2017 May
REPOSITORIES: biostudies-literature
Aoki Shuichi S Miyata Hiroaki H Konno Hiroyuki H Gotoh Mitsukazu M Motoi Fuyuhiko F Kumamaru Hiraku H Wakabayashi Go G Kakeji Yoshihiro Y Mori Masaki M Seto Yasuyuki Y Unno Michiaki M
Journal of hepato-biliary-pancreatic sciences 20170405 5
<h4>Background</h4>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.<h4>Methods</h4>Between 2011 and 2012, data from 17,564 patients who underwent pancreaticoduodenectomy at 1,311 institutions in Japan were recorded in this database. The ...[more]