Assessment of two different criteria for post-pancreatectomy acute pancreatitis: a single-center retrospective analysis and literature review.

IF 2.7 3区医学 Q2 GASTROENTEROLOGY & HEPATOLOGY

Hpb Pub Date : 2025-04-19 DOI:10.1016/j.hpb.2025.04.010

Asahi Sato, Akie Tani, Yusuke Mishima, Takahito Ohmine, Jun Ichikawa, Masaki Tani, Kosuke Toda, Takefumi Yazawa, Ben Sasaki, Hidenori Ohe, Masahiro Yamada, Kenya Yamanaka

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引用次数: 0

Abstract

Background: The significance of postoperative acute pancreatitis (postoperative pancreatitis [POP] as defined by Connor and post-pancreatectomy acute pancreatitis [PPAP] as defined by the International Study Group for Pancreatic Surgery [ISGPS]) has not been determined because of the transition of definitions, a lack of prospective studies and ignorance regarding appropriate management.

Methods: The incidence of POP/PPAP were retrospectively analyzed. Additionally, the clinicopathological parameters and outcomes were compared between patients with and without POP/PPAP.

Results: Using Connor's criteria, 46% of patients (70/151) showed Grade A POP and 17% (26/151) displayed clinically relevant (CR)-POP. Using ISGPS criteria, the prevalences of postoperative hyperamylasemia and CR-PPAP were 12% (18/151) and 10% (15/151), respectively. The duration of antibiotics and carbapenem were longer in CR-POP (p < 0.001). Total health care cost was significantly higher in CR-POP compared with other grades in Connor's criteria (p = 0.010), whereas no difference was seen in the ISGPS criteria (p = 0.677). The frequencies of complications including pancreatic fistula (Non-POP vs. Grade A POP vs. CR-POP, 22% vs. 36% vs. 81%, p < 0.001), reoperation and length of hospital stay tended to be greater as Connor's grade of POP increased.

Discussion: Connor's definition appeared more closely associated with postoperative worse outcomes than the ISGPS definition.

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评估胰腺切除术后急性胰腺炎的两种不同标准：单中心回顾性分析和文献综述。

背景：术后急性胰腺炎（Connor定义的术后胰腺炎[POP]和国际胰腺外科研究小组[ISGPS]定义的胰腺切除术后急性胰腺炎[PPAP]）的重要性尚未确定，因为定义的转变，缺乏前瞻性研究和对适当管理的无知。方法：回顾性分析POP/PPAP的发病情况。此外，比较了POP/PPAP患者和非POP/PPAP患者的临床病理参数和结果。结果：采用Connor’s标准，46%（70/151）的患者表现为A级POP， 17%（26/151）的患者表现为临床相关(CR)-POP。采用ISGPS标准，术后高淀粉酶血症和CR-PPAP的患病率分别为12%（18/151）和10%（15/151）。CR-POP组抗生素和碳青霉烯类药物使用时间较长（p < 0.001）。在Connor标准中，CR-POP的总医疗保健费用显著高于其他等级（p = 0.010），而在ISGPS标准中没有差异（p = 0.677）。胰瘘（非POP、A级POP、CR-POP， 22%、36%、81%,p < 0.001）、再手术和住院时间随着Connor的POP分级的增加而增加。讨论：与ISGPS定义相比，Connor定义与术后不良预后的关系更为密切。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Hpb GASTROENTEROLOGY & HEPATOLOGY-SURGERY

CiteScore

5.60

自引率

3.40%

发文量

244

审稿时长

57 days

期刊介绍： HPB is an international forum for clinical, scientific and educational communication. Twelve issues a year bring the reader leading articles, expert reviews, original articles, images, editorials, and reader correspondence encompassing all aspects of benign and malignant hepatobiliary disease and its management. HPB features relevant aspects of clinical and translational research and practice. Specific areas of interest include HPB diseases encountered globally by clinical practitioners in this specialist field of gastrointestinal surgery. The journal addresses the challenges faced in the management of cancer involving the liver, biliary system and pancreas. While surgical oncology represents a large part of HPB practice, submission of manuscripts relating to liver and pancreas transplantation, the treatment of benign conditions such as acute and chronic pancreatitis, and those relating to hepatobiliary infection and inflammation are also welcomed. There will be a focus on developing a multidisciplinary approach to diagnosis and treatment with endoscopic and laparoscopic approaches, radiological interventions and surgical techniques being strongly represented. HPB welcomes submission of manuscripts in all these areas and in scientific focused research that has clear clinical relevance to HPB surgical practice. HPB aims to help its readers - surgeons, physicians, radiologists and basic scientists - to develop their knowledge and practice. HPB will be of interest to specialists involved in the management of hepatobiliary and pancreatic disease however will also inform those working in related fields. Abstracted and Indexed in: MEDLINE® EMBASE PubMed Science Citation Index Expanded Academic Search (EBSCO) HPB is owned by the International Hepato-Pancreato-Biliary Association (IHPBA) and is also the official Journal of the American Hepato-Pancreato-Biliary Association (AHPBA), the Asian-Pacific Hepato Pancreatic Biliary Association (A-PHPBA) and the European-African Hepato-Pancreatic Biliary Association (E-AHPBA).