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Evaluation of Postoperative Pancreatic Fistula After Total Gastrectomy with D2 Lymphadenectomy by ISGPF Classification

  • Original Article
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Journal of Gastrointestinal Surgery Aims and scope

Abstract

Introduction

Postoperative pancreatic fistula (POPF) is a serious complication of total gastrectomy (TG) with D2 lymphadenectomy (D2). However, the actual incidence and risk factors are not yet completely understood, due in part to the absence of the widely accepted criteria for POPF following gastrectomy.

Patients and methods

One hundred and four patients who underwent TG with D2 between March 2007 and December 2009 were included in this study. The incidence and severity of POPF were evaluated according to the International Study Group on Pancreatic Fistula (ISGPF) classification. In addition, risk factors for POPF of ISGPF grade B or higher were investigated.

Results

POPFs of ISGPF grade B or higher were observed in 23 patients (22.1%). Univariate analysis found that sex, body mass index, and amylase concentration of drainage fluid (d-AMY) on the first postoperative day (1POD) were significant predictors of POPF grade B or higher. The appropriate cutoff level of d-AMY on 1POD was calculated as 3398 IU/l. Multivariate analysis showed that d-AMY ≥3,398 IU/l on 1POD was the only independent risk factor.

Conclusions

High d-AMY on 1POD (≥3,398 IU/l) can predict a grade B or higher POPF, and this value may be useful in the early detection of POPF following TG with D2.

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Acknowledgments

This research was partially supported by a Grant-in-Aid for Scientific Research from the Ministry of Health, Labour and Welfare of Japan. The authors declare no conflict of interest.

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Authors and Affiliations

  1. Department of Gastric Surgery, Shizuoka Cancer Center, 1007, Shimonagakubo, Nagaizumi-cho, Shizuoka, 411-8777, Japan

    Yuichiro Miki, Masanori Tokunaga, Etsuro Bando, Yutaka Tanizawa, Taiichi Kawamura & Masanori Terashima

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  1. Yuichiro Miki
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  2. Masanori Tokunaga
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  3. Etsuro Bando
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  4. Yutaka Tanizawa
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Correspondence to Masanori Terashima.

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Miki, Y., Tokunaga, M., Bando, E. et al. Evaluation of Postoperative Pancreatic Fistula After Total Gastrectomy with D2 Lymphadenectomy by ISGPF Classification. J Gastrointest Surg 15, 1969–1976 (2011). https://doi.org/10.1007/s11605-011-1628-1

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  • DOI: https://doi.org/10.1007/s11605-011-1628-1

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