Protective or Risk Factors for Postoperative Pancreatic Fistulas in Malignant Pathology

Introduction: Malignant tumors are associated with a low incidence of postoperative pancreatic fistulas. The presence of peritumoral fibrosis is considered the protective factor for the development of postoperative pancreatic fistulas after pancreatic resections for pancreatic ductal adenocarcinomas...

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Autores principales:	Alin Mihai Vasilescu, Delia Florina Andriesi Rusu, Costel Bradea, Nutu Vlad, Corina Lupascu-Ursulescu, Irene Alexandra Cianga Spiridon, Ana Maria Trofin, Eugen Tarcoveanu, Cristian Dumitru Lupascu
Formato:	article
Lenguaje:	EN
Publicado:	MDPI AG 2021
Materias:	pancreatic ductal adenocarcinomas pancreatic fistula histological aspects Science Q
Acceso en línea:	https://doaj.org/article/eb54416155d14e4fbe3e00602e4b8c7a
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spelling	oai:doaj.org-article:eb54416155d14e4fbe3e00602e4b8c7a2021-11-25T18:11:17ZProtective or Risk Factors for Postoperative Pancreatic Fistulas in Malignant Pathology10.3390/life111112162075-1729https://doaj.org/article/eb54416155d14e4fbe3e00602e4b8c7a2021-11-01T00:00:00Zhttps://www.mdpi.com/2075-1729/11/11/1216https://doaj.org/toc/2075-1729Introduction: Malignant tumors are associated with a low incidence of postoperative pancreatic fistulas. The presence of peritumoral fibrosis is considered the protective factor for the development of postoperative pancreatic fistulas after pancreatic resections for pancreatic ductal adenocarcinomas. Methods: We analyzed a series of 109 consecutive patients with pancreatic resections for malignant pathology: pancreatic ductal adenocarcinomas and periampullary adenocarcinomas. The incidence of postoperative pancreatic fistulas has been reported in tumor histological type, in the presence of peritumoral fibrosis, and in the association between adenocarcinomas and areas of acute pancreatitis. The data obtained were processed with the statistical analysis program SPSS, and statistically significant <i>p</i> were considered at a value <0.05. Results: For the entire study group, the incidence of postoperative pancreatic fistulas was 11.01%. The lowest incidence was observed in the group of patients with pancreatic ductal adenocarcinomas (4.06% vs. 25.72% in the group with periampullary adenocarcinoma), with a <i>p</i> = 0.002. The presence of peritumoral fibrous tissue was observed in 49.31% of cases without pancreatic fistulas, and in 54.54% of cases that developed this postoperative complication (<i>p</i> = 0.5). Also, the peritumoral fibrous tissue had a uniform distribution depending on the main diagnosis (56.14% in pancreatic ductal adenocarcinoma group vs. 37.04% in periampullary adenocarcinoma group, with a <i>p</i> = 0.08). In the group of patients who associated areas of acute pancreatitis on the resections, the incidence of postoperative pancreatic fistulas was 7.8 times higher (30% vs. 3.8%, <i>p</i> = 0.026). Conclusions: Peritumoral fibrous tissue was not a factor involved in the developing of postoperative pancreatic fistulas. The association of adenocarciomas with areas of acute pancreatitis has led to a significant increase in postoperative pancreatic fistulas, which is a significant and independent risk factor.Alin Mihai VasilescuDelia Florina Andriesi RusuCostel BradeaNutu VladCorina Lupascu-UrsulescuIrene Alexandra Cianga SpiridonAna Maria TrofinEugen TarcoveanuCristian Dumitru LupascuMDPI AGarticlepancreatic ductal adenocarcinomaspancreatic fistulahistological aspectsScienceQENLife, Vol 11, Iss 1216, p 1216 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	pancreatic ductal adenocarcinomas pancreatic fistula histological aspects Science Q
spellingShingle	pancreatic ductal adenocarcinomas pancreatic fistula histological aspects Science Q Alin Mihai Vasilescu Delia Florina Andriesi Rusu Costel Bradea Nutu Vlad Corina Lupascu-Ursulescu Irene Alexandra Cianga Spiridon Ana Maria Trofin Eugen Tarcoveanu Cristian Dumitru Lupascu Protective or Risk Factors for Postoperative Pancreatic Fistulas in Malignant Pathology
description	Introduction: Malignant tumors are associated with a low incidence of postoperative pancreatic fistulas. The presence of peritumoral fibrosis is considered the protective factor for the development of postoperative pancreatic fistulas after pancreatic resections for pancreatic ductal adenocarcinomas. Methods: We analyzed a series of 109 consecutive patients with pancreatic resections for malignant pathology: pancreatic ductal adenocarcinomas and periampullary adenocarcinomas. The incidence of postoperative pancreatic fistulas has been reported in tumor histological type, in the presence of peritumoral fibrosis, and in the association between adenocarcinomas and areas of acute pancreatitis. The data obtained were processed with the statistical analysis program SPSS, and statistically significant <i>p</i> were considered at a value <0.05. Results: For the entire study group, the incidence of postoperative pancreatic fistulas was 11.01%. The lowest incidence was observed in the group of patients with pancreatic ductal adenocarcinomas (4.06% vs. 25.72% in the group with periampullary adenocarcinoma), with a <i>p</i> = 0.002. The presence of peritumoral fibrous tissue was observed in 49.31% of cases without pancreatic fistulas, and in 54.54% of cases that developed this postoperative complication (<i>p</i> = 0.5). Also, the peritumoral fibrous tissue had a uniform distribution depending on the main diagnosis (56.14% in pancreatic ductal adenocarcinoma group vs. 37.04% in periampullary adenocarcinoma group, with a <i>p</i> = 0.08). In the group of patients who associated areas of acute pancreatitis on the resections, the incidence of postoperative pancreatic fistulas was 7.8 times higher (30% vs. 3.8%, <i>p</i> = 0.026). Conclusions: Peritumoral fibrous tissue was not a factor involved in the developing of postoperative pancreatic fistulas. The association of adenocarciomas with areas of acute pancreatitis has led to a significant increase in postoperative pancreatic fistulas, which is a significant and independent risk factor.
format	article
author	Alin Mihai Vasilescu Delia Florina Andriesi Rusu Costel Bradea Nutu Vlad Corina Lupascu-Ursulescu Irene Alexandra Cianga Spiridon Ana Maria Trofin Eugen Tarcoveanu Cristian Dumitru Lupascu
author_facet	Alin Mihai Vasilescu Delia Florina Andriesi Rusu Costel Bradea Nutu Vlad Corina Lupascu-Ursulescu Irene Alexandra Cianga Spiridon Ana Maria Trofin Eugen Tarcoveanu Cristian Dumitru Lupascu
author_sort	Alin Mihai Vasilescu
title	Protective or Risk Factors for Postoperative Pancreatic Fistulas in Malignant Pathology
title_short	Protective or Risk Factors for Postoperative Pancreatic Fistulas in Malignant Pathology
title_full	Protective or Risk Factors for Postoperative Pancreatic Fistulas in Malignant Pathology
title_fullStr	Protective or Risk Factors for Postoperative Pancreatic Fistulas in Malignant Pathology
title_full_unstemmed	Protective or Risk Factors for Postoperative Pancreatic Fistulas in Malignant Pathology
title_sort	protective or risk factors for postoperative pancreatic fistulas in malignant pathology
publisher	MDPI AG
publishDate	2021
url	https://doaj.org/article/eb54416155d14e4fbe3e00602e4b8c7a
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Protective or Risk Factors for Postoperative Pancreatic Fistulas in Malignant Pathology

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