Predictors of Postoperative Pancreatic Fistula (POPF) After Pancreaticoduodenectomy: Clinical Significance of the Mean Platelet Volume (MPV)/Platelet Count Ratio as a New Predictor.
J Gastrointest Surg
; 26(2): 387-397, 2022 02.
Article
em En
| MEDLINE
| ID: mdl-34545541
ABSTRACT
PURPOSE:
In this study, it was aimed to determine the predictors of clinically relevant postoperative pancreatic fistula (CR-POPF) following pancreaticoduodenectomy (PD) and clinical significance of mean platelet volume (MPV)/total platelet count ratio (MPR) as a new predictor for CR-POPF.METHODS:
A total of 105 patients who underwent PD consecutively due to periampullary located diseases were included in the study. Patients were divided into two groups as CR-POPF and no postoperative pancreatic fistula (No-POPF). Demographic parameters, preoperative serum-based inflammatory indicators, surgical procedures, intraoperative findings, and histopathological parameters were recorded retrospectively from prospectively recorded patient files and compared between the groups.RESULTS:
CR-POPF occurred in 16 (15.2%) patients 8 (7.6%) were grade B and 8 (7.6%) were grade C according to the ISGPF classification. In univariate analysis, intraoperative blood loss > 580 mL (OR 5.25, p = 0.001), intraoperative blood transfusion (OR 5.96, p = 0.002), intraoperative vasoconstrictor medication (OR 4.17, p = 0.014), benign histopathology (OR 3.51, p = 0.036), and poor differentiation in malignant tumors (OR 4.07, p = 0.044) were significantly higher in the CR-POPF group, but not significant in multivariate analysis. Soft pancreatic consistency (OR 6.08, p = 0.013), pancreatic duct diameter < 2.5 mm (OR 17.15, p < 0.001), and MPR < 28.9 (OR 13.91, p < 0.001) were the independent predictors of CR-POPF according to multivariate analysis. Neoadjuvant treatment history and simultaneous vascular resection were less likely to cause CR-POPF development; however, they were insignificant.CONCLUSION:
Soft pancreatic consistency, pancreatic duct diameter, and preoperative MPR were the independent predictors of CR-POPF following PD. Decreased MPR is a strong predictor for CR-POPF and should be considered when deciding treatment strategies.Palavras-chave
Texto completo:
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Base de dados:
MEDLINE
Assunto principal:
Fístula Pancreática
/
Pancreaticoduodenectomia
Tipo de estudo:
Diagnostic_studies
/
Etiology_studies
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Observational_studies
/
Prognostic_studies
/
Risk_factors_studies
Limite:
Humans
Idioma:
En
Ano de publicação:
2022
Tipo de documento:
Article