Postoperative Pancreatic Fistula and the Risk Factors of Laparoscopy-Assisted Distal Gastrectomy for Early Gastric Cancer View Full Text


Ontology type: schema:ScholarlyArticle     


Article Info

DATE

2012-01

AUTHORS

Xiaohua Jiang, Naoki Hiki, Souya Nunobe, Koshi Kumagai, Kyoko Nohara, Takeshi Sano, Toshiharu Yamaguchi

ABSTRACT

BACKGROUND: Laparoscopy-assisted distal gastrectomy (LADG) was introduced as minimally invasive surgery for early gastric cancer (EGC) in Japan. This study investigated postoperative pancreatic fistula (POPF) and associated risk factors of the procedure. METHODS: From January 2005 to December 2009, 798 patients with EGC diagnosed before surgery underwent LADG. Thirty-four patients developed postoperative pancreatic fistula (POPF group), whereas the other 764 patients did not experience POPF (NPOPF group). POPF was defined and graded according to the International Study Group on Pancreatic Fistula Definition (ISGPF). Patient characteristics and operative and postoperative outcomes were compared between the two groups. Risk factors associated with POPF were analyzed. RESULTS: POPF occurred in 34 (4.3%) patients; among them 3 developed grade C POPF, a complication that required aggressive clinical intervention, and only 1 underwent reoperation. Compared with the NPOPF group, the POPF group had higher percentage of male patients (88.2% vs. 60.5%, P = 0.001), higher mean body mass index (24.8 ± 2.5 kg/m(2) vs. 22.5 ± 3.2 kg/m(2), P < 0.001), longer mean operation time (251.3 ± 46.7 min vs. 229.7 ± 53.9 min, P = 0.022), higher postoperative complications (100% vs. 8.6%, P < 0.001), and longer mean postoperative hospital stay (29.6 ± 19.9 days vs. 12.6 ± 6.7 days, P < 0.001). Univariate and multivariate analysis identified sex and body mass index as risk factors associated with POPF after LADG. CONCLUSIONS: LADG can be performed safely in patients with EGC in terms of the low incidence of POPF. To decrease the risk of POPF, LADG should be performed cautiously in male patients with high body mass index. More... »

PAGES

115-121

References to SciGraph publications

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  • Identifiers

    URI

    http://scigraph.springernature.com/pub.10.1245/s10434-011-1893-y

    DOI

    http://dx.doi.org/10.1245/s10434-011-1893-y

    DIMENSIONS

    https://app.dimensions.ai/details/publication/pub.1025053069

    PUBMED

    https://www.ncbi.nlm.nih.gov/pubmed/21739317


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