Detailed Abstract
[Plenary Session]
[PL 3] Lack of association between postoperative acute pancreatitis and postoperative complications following pancreaticoduodenectomy
Daegwang YOO1, Seo Young PARK2, Dae Wook HWANG*3, Jae Hoon LEE3, Ki Byung SONG3, Woohyung LEE3, Jaewoo KWON3, Yejong PARK3, Eunsung JUN3, Sarang HONG3, Jong Woo LEE3, Kyungyeon HWANG3, Dakyum SHIN3, Song Cheol KIM3
1Hepatobiliary pancreatic surgery, Chungju Kunkuk university hospital, Korea
2Department of Clinical Epidemiology and Biostatistics, Asan medical center, Korea
3Hepatobiliary pancreatic surgery, Asan medical center, Korea
Introduction : Prediction of post-PD morbidity is difficult especially in the early postoperative period when CT scans are not available. Elevated serum amylase and lipase in postoperative day 0 or 1 may be used to define POAP, but existing literature do not agree on whether POAP is significantly associated with POPF. The objective of this study is to evaluate the association between postoperative acute pancreatitis (POAP) and postoperative complications including postoperative pancreatic fistula (POPF) in patients undergoing pancreaticoduodenectomy (PD).
Methods : We analyzed the data obtained from a previously published randomized controlled trial. POAP was defined as elevations in serum amylase above 110 U/L on postoperative day 0 or 1. Clinically relevant POAP (CR-POAP) was defined as elevations in CRP on postoperative day 2 in those with POAP. Postoperative complications including severe complications (Clavien–Dindo ≥ IIIa), POPF, and clinically relevant POPF (CR-POPF; grades B or C) were analyzed. For a robust selection of variables for multivariable analysis, 500 bootstrap samples were drawn from the original data and backward elimination was performed while forcing POAP to be included.
Results : In 246 patients, POAP did not show significant associations with total postoperative complications (odds ratio [OR] 0.697; 95% CI, 0.360–1.313; P = 0.271), severe complications (OR 0.647; 95% CI, 0.258–1.747; P = 0.367), and CR-POPF (OR 0.998; 95% CI, 0.310–3.886; P = 0.998) in multivariable analysis.
Conclusions : In patients undergoing PD, POAP was not significantly associated with postoperative complications including POPF. Caution should be taken when using POAP as a predictor of POPF.
Methods : We analyzed the data obtained from a previously published randomized controlled trial. POAP was defined as elevations in serum amylase above 110 U/L on postoperative day 0 or 1. Clinically relevant POAP (CR-POAP) was defined as elevations in CRP on postoperative day 2 in those with POAP. Postoperative complications including severe complications (Clavien–Dindo ≥ IIIa), POPF, and clinically relevant POPF (CR-POPF; grades B or C) were analyzed. For a robust selection of variables for multivariable analysis, 500 bootstrap samples were drawn from the original data and backward elimination was performed while forcing POAP to be included.
Results : In 246 patients, POAP did not show significant associations with total postoperative complications (odds ratio [OR] 0.697; 95% CI, 0.360–1.313; P = 0.271), severe complications (OR 0.647; 95% CI, 0.258–1.747; P = 0.367), and CR-POPF (OR 0.998; 95% CI, 0.310–3.886; P = 0.998) in multivariable analysis.
Conclusions : In patients undergoing PD, POAP was not significantly associated with postoperative complications including POPF. Caution should be taken when using POAP as a predictor of POPF.
SESSION
Plenary Session
Room A 7/29/2020 11:30 AM - 11:45 AM