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
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Publicado: Public Library of Science (PLoS) 2021
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spelling oai:doaj.org-article:db4256eebfbb40c195196e7f615854ae2021-12-02T20:07:41ZOptimal management of peripancreatic fluid collection with postoperative pancreatic fistula after distal pancreatectomy: Significance of computed tomography values for predicting fluid infection.1932-620310.1371/journal.pone.0259701https://doaj.org/article/db4256eebfbb40c195196e7f615854ae2021-01-01T00:00:00Zhttps://doi.org/10.1371/journal.pone.0259701https://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, p e0259701 (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/db4256eebfbb40c195196e7f615854ae
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