Optimal management of peripancreatic fluid collection with postoperative pancreatic fistula after distal pancreatectomy: Significance of computed tomography values for predicting fluid infection

Peripancreatic fluid collections have been observed in most patients with postoperative pancreatic fistula after distal pancreatectomy; however, optimal management remains unclear. This study aimed to evaluate the management and outcomes of patients with postoperative pancreatic fistula and verify t...

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Autores principales:	Koki Maeda, Naohisa Kuriyama, Yuki Nakagawa, Takahiro Ito, Aoi Hayasaki, Kazuyuki Gyoten, Takehiro Fujii, Yusuke Iizawa, Yasuhiro Murata, Akihiro Tanemura, Masashi Kishiwada, Hiroyuki Sakurai, Shugo Mizuno
Formato:	article
Lenguaje:	EN
Publicado:	Public Library of Science (PLoS) 2021
Materias:	Medicine R Science Q
Acceso en línea:	https://doaj.org/article/6f0a188f9366412dbece85759f11faa6
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spelling	oai:doaj.org-article:6f0a188f9366412dbece85759f11faa62021-11-18T06:34:25ZOptimal management of peripancreatic fluid collection with postoperative pancreatic fistula after distal pancreatectomy: Significance of computed tomography values for predicting fluid infection1932-6203https://doaj.org/article/6f0a188f9366412dbece85759f11faa62021-01-01T00:00:00Zhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC8577730/?tool=EBIhttps://doaj.org/toc/1932-6203Peripancreatic fluid collections have been observed in most patients with postoperative pancreatic fistula after distal pancreatectomy; however, optimal management remains unclear. This study aimed to evaluate the management and outcomes of patients with postoperative pancreatic fistula and verify the significance of computed tomography values for predicting peripancreatic fluid infections after distal pancreatectomy. We retrospectively investigated 259 consecutive patients who underwent distal pancreatectomy. Grade B postoperative pancreatic fistula patients were divided into two subgroups (B-antibiotics group and B-intervention group) and outcomes were compared. Predictive factor analysis of peripancreatic fluid infection was performed. Clinically relevant postoperative pancreatic fistulas developed in 88 (34.0%) patients. The duration of hospitalization was significantly longer in the B-intervention (n = 54) group than in the B-antibiotics group (n = 31; 41 vs. 17 days, p < 0.001). Computed tomography values of the infected peripancreatic fluid collections were significantly higher than those of the non-infected peripancreatic fluid collections (26.3 vs. 16.1 Hounsfield units, respectively; p < 0.001). The outcomes of the patients with grade B postoperative pancreatic fistulas who received therapeutic antibiotics only were considerably better than those who underwent interventions. Computed tomography values may be useful in predicting peripancreatic fluid collection infection after distal pancreatectomy.Koki MaedaNaohisa KuriyamaYuki NakagawaTakahiro ItoAoi HayasakiKazuyuki GyotenTakehiro FujiiYusuke IizawaYasuhiro MurataAkihiro TanemuraMasashi KishiwadaHiroyuki SakuraiShugo MizunoPublic Library of Science (PLoS)articleMedicineRScienceQENPLoS ONE, Vol 16, Iss 11 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	Medicine R Science Q
spellingShingle	Medicine R Science Q Koki Maeda Naohisa Kuriyama Yuki Nakagawa Takahiro Ito Aoi Hayasaki Kazuyuki Gyoten Takehiro Fujii Yusuke Iizawa Yasuhiro Murata Akihiro Tanemura Masashi Kishiwada Hiroyuki Sakurai Shugo Mizuno Optimal management of peripancreatic fluid collection with postoperative pancreatic fistula after distal pancreatectomy: Significance of computed tomography values for predicting fluid infection
description	Peripancreatic fluid collections have been observed in most patients with postoperative pancreatic fistula after distal pancreatectomy; however, optimal management remains unclear. This study aimed to evaluate the management and outcomes of patients with postoperative pancreatic fistula and verify the significance of computed tomography values for predicting peripancreatic fluid infections after distal pancreatectomy. We retrospectively investigated 259 consecutive patients who underwent distal pancreatectomy. Grade B postoperative pancreatic fistula patients were divided into two subgroups (B-antibiotics group and B-intervention group) and outcomes were compared. Predictive factor analysis of peripancreatic fluid infection was performed. Clinically relevant postoperative pancreatic fistulas developed in 88 (34.0%) patients. The duration of hospitalization was significantly longer in the B-intervention (n = 54) group than in the B-antibiotics group (n = 31; 41 vs. 17 days, p < 0.001). Computed tomography values of the infected peripancreatic fluid collections were significantly higher than those of the non-infected peripancreatic fluid collections (26.3 vs. 16.1 Hounsfield units, respectively; p < 0.001). The outcomes of the patients with grade B postoperative pancreatic fistulas who received therapeutic antibiotics only were considerably better than those who underwent interventions. Computed tomography values may be useful in predicting peripancreatic fluid collection infection after distal pancreatectomy.
format	article
author	Koki Maeda Naohisa Kuriyama Yuki Nakagawa Takahiro Ito Aoi Hayasaki Kazuyuki Gyoten Takehiro Fujii Yusuke Iizawa Yasuhiro Murata Akihiro Tanemura Masashi Kishiwada Hiroyuki Sakurai Shugo Mizuno
author_facet	Koki Maeda Naohisa Kuriyama Yuki Nakagawa Takahiro Ito Aoi Hayasaki Kazuyuki Gyoten Takehiro Fujii Yusuke Iizawa Yasuhiro Murata Akihiro Tanemura Masashi Kishiwada Hiroyuki Sakurai Shugo Mizuno
author_sort	Koki Maeda
title	Optimal management of peripancreatic fluid collection with postoperative pancreatic fistula after distal pancreatectomy: Significance of computed tomography values for predicting fluid infection
title_short	Optimal management of peripancreatic fluid collection with postoperative pancreatic fistula after distal pancreatectomy: Significance of computed tomography values for predicting fluid infection
title_full	Optimal management of peripancreatic fluid collection with postoperative pancreatic fistula after distal pancreatectomy: Significance of computed tomography values for predicting fluid infection
title_fullStr	Optimal management of peripancreatic fluid collection with postoperative pancreatic fistula after distal pancreatectomy: Significance of computed tomography values for predicting fluid infection
title_full_unstemmed	Optimal management of peripancreatic fluid collection with postoperative pancreatic fistula after distal pancreatectomy: Significance of computed tomography values for predicting fluid infection
title_sort	optimal management of peripancreatic fluid collection with postoperative pancreatic fistula after distal pancreatectomy: significance of computed tomography values for predicting fluid infection
publisher	Public Library of Science (PLoS)
publishDate	2021
url	https://doaj.org/article/6f0a188f9366412dbece85759f11faa6
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Optimal management of peripancreatic fluid collection with postoperative pancreatic fistula after distal pancreatectomy: Significance of computed tomography values for predicting fluid infection

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