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Risk Factors of Addeo et al for Pancreatic Fistula After Pancreaticoduodenectomy for Pancreatic Adenocarcinoma

Description

Addeo et al identified risk factors for pancreatic fistula following a pancreaticoduodenectomy for pancreatic adenocarcinoma. These can help to identify a patient who may require more aggressive management. The authors are from multiple hospitals in France, the French Surgical Association and the Permanente Medical Group (Walnut Creek, CA).


Patient selection: pancreaticoduodenectomy for pancreatic adenocarcinoma

 

Criteria for pancreatic fistula: any measurable drainage from a drain placed at surgery 3 or more days after surgery with an amylase concentration that is >= 3 times the upper limit of normal for serum amylase

 

Risk factors for pancreatic fistula:

(1) absence of pre-operative diabetes mellitus

(2) reconstruction with pancreaticojejunostomy (versus pancreaticogastrostomy)

(3) soft pancreatic parenchyma (versus normal or firm)

(4) low volume surgical center

 

The risk for fistula increased with the number of risk factors present.

 


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