PortalPublikationenOptions and limitations in applying the fistula classificati...

Options and limitations in applying the fistula classification by the International Study Group for Pancreatic Fistula

Standard

Options and limitations in applying the fistula classification by the International Study Group for Pancreatic Fistula. / Gebauer, Florian; Kloth, Katja; Tachezy, Michael; Vashist, Yogesh K; Cataldegirmen, Guellue; Izbicki, Jakob R; Bockhorn, Maximilliam; Bockhorn, Maximilian.

in: ANN SURG, Jahrgang 256, Nr. 1, 01.07.2012, S. 130-8.

Publikationen: SCORING: Beitrag in Fachzeitschrift/Zeitung › SCORING: Zeitschriftenaufsatz › Forschung › Begutachtung

Harvard

Gebauer, F, Kloth, K, Tachezy, M, Vashist, YK, Cataldegirmen, G, Izbicki, JR, Bockhorn, M & Bockhorn, M 2012, 'Options and limitations in applying the fistula classification by the International Study Group for Pancreatic Fistula', ANN SURG, Jg. 256, Nr. 1, S. 130-8. https://doi.org/10.1097/SLA.0b013e31824f24e4

APA

Gebauer, F., Kloth, K., Tachezy, M., Vashist, Y. K., Cataldegirmen, G., Izbicki, J. R., Bockhorn, M., & Bockhorn, M. (2012). Options and limitations in applying the fistula classification by the International Study Group for Pancreatic Fistula. ANN SURG, 256(1), 130-8. https://doi.org/10.1097/SLA.0b013e31824f24e4

Vancouver

Gebauer F, Kloth K, Tachezy M, Vashist YK, Cataldegirmen G, Izbicki JR et al. Options and limitations in applying the fistula classification by the International Study Group for Pancreatic Fistula. ANN SURG. 2012 Jul 1;256(1):130-8. https://doi.org/10.1097/SLA.0b013e31824f24e4

Bibtex

@article{777a81ef33604d7ba97be85ff47d187d,
title = "Options and limitations in applying the fistula classification by the International Study Group for Pancreatic Fistula",
abstract = "BACKGROUND: Because of its retrospective character, the classification system of the International Study Group of Pancreatic Fistula (ISGPF) lacks prognostic capacity regarding fistula-related complications. This study aimed to evaluate the options and limitations of the ISGPF classification system and to identify risk factors with respect to clinical decision making.METHODS: Between 1992 and 2009, 1966 patients underwent surgery of the pancreas. All patient data were entered into a prospective clinical data management system.RESULTS: After surgery, 276 patients (14%) developed postoperative pancreatic fistula (POPF). ISGPF type A fistula was seen in 69 patients (25%), type B in 110 (39.9%), and type C in 97 (34.1%). Solely due to their death, 16 patients had to be classified as type C fistula, even though they suffered only type A or B. Compared to genuine C fistulas, we were not able to detect any significant predictors, which may allow to distinguish the development in their further clinical course. The level of drainage amylase is of no use, whereas univariate analysis identified underlying disease, type of operation, and high levels of serum amylase or bilirubin on the day of onset of POPF to be prognostic parameters for reoperation. Multivariate analysis found elevated serum C-reactive protein to be an independent factor for increased in-hospital mortality.CONCLUSIONS: The ISGPF classification system has its limitations in clinical decision making, because it does not adequately describe a large subgroup of patients. To improve clinical decision making about management of patients, it is crucial that the ISGPF classification system is merged with newer clinical data.",
keywords = "Adenocarcinoma, Adult, Aged, Aged, 80 and over, Amylases, Bile Duct Neoplasms, Bilirubin, C-Reactive Protein, Decision Making, Female, Hospital Mortality, Humans, Logistic Models, Male, Middle Aged, Multivariate Analysis, Pancreatic Fistula, Pancreaticoduodenectomy, Pancreatitis, Chronic",
author = "Florian Gebauer and Katja Kloth and Michael Tachezy and Vashist, {Yogesh K} and Guellue Cataldegirmen and Izbicki, {Jakob R} and Maximilliam Bockhorn and Maximilian Bockhorn",
year = "2012",
month = jul,
day = "1",
doi = "10.1097/SLA.0b013e31824f24e4",
language = "English",
volume = "256",
pages = "130--8",
journal = "ANN SURG",
issn = "0003-4932",
publisher = "Lippincott Williams and Wilkins",
number = "1",

}

RIS

TY - JOUR

T1 - Options and limitations in applying the fistula classification by the International Study Group for Pancreatic Fistula

AU - Gebauer, Florian

AU - Kloth, Katja

AU - Tachezy, Michael

AU - Vashist, Yogesh K

AU - Cataldegirmen, Guellue

AU - Izbicki, Jakob R

AU - Bockhorn, Maximilliam

AU - Bockhorn, Maximilian

PY - 2012/7/1

Y1 - 2012/7/1

N2 - BACKGROUND: Because of its retrospective character, the classification system of the International Study Group of Pancreatic Fistula (ISGPF) lacks prognostic capacity regarding fistula-related complications. This study aimed to evaluate the options and limitations of the ISGPF classification system and to identify risk factors with respect to clinical decision making.METHODS: Between 1992 and 2009, 1966 patients underwent surgery of the pancreas. All patient data were entered into a prospective clinical data management system.RESULTS: After surgery, 276 patients (14%) developed postoperative pancreatic fistula (POPF). ISGPF type A fistula was seen in 69 patients (25%), type B in 110 (39.9%), and type C in 97 (34.1%). Solely due to their death, 16 patients had to be classified as type C fistula, even though they suffered only type A or B. Compared to genuine C fistulas, we were not able to detect any significant predictors, which may allow to distinguish the development in their further clinical course. The level of drainage amylase is of no use, whereas univariate analysis identified underlying disease, type of operation, and high levels of serum amylase or bilirubin on the day of onset of POPF to be prognostic parameters for reoperation. Multivariate analysis found elevated serum C-reactive protein to be an independent factor for increased in-hospital mortality.CONCLUSIONS: The ISGPF classification system has its limitations in clinical decision making, because it does not adequately describe a large subgroup of patients. To improve clinical decision making about management of patients, it is crucial that the ISGPF classification system is merged with newer clinical data.

AB - BACKGROUND: Because of its retrospective character, the classification system of the International Study Group of Pancreatic Fistula (ISGPF) lacks prognostic capacity regarding fistula-related complications. This study aimed to evaluate the options and limitations of the ISGPF classification system and to identify risk factors with respect to clinical decision making.METHODS: Between 1992 and 2009, 1966 patients underwent surgery of the pancreas. All patient data were entered into a prospective clinical data management system.RESULTS: After surgery, 276 patients (14%) developed postoperative pancreatic fistula (POPF). ISGPF type A fistula was seen in 69 patients (25%), type B in 110 (39.9%), and type C in 97 (34.1%). Solely due to their death, 16 patients had to be classified as type C fistula, even though they suffered only type A or B. Compared to genuine C fistulas, we were not able to detect any significant predictors, which may allow to distinguish the development in their further clinical course. The level of drainage amylase is of no use, whereas univariate analysis identified underlying disease, type of operation, and high levels of serum amylase or bilirubin on the day of onset of POPF to be prognostic parameters for reoperation. Multivariate analysis found elevated serum C-reactive protein to be an independent factor for increased in-hospital mortality.CONCLUSIONS: The ISGPF classification system has its limitations in clinical decision making, because it does not adequately describe a large subgroup of patients. To improve clinical decision making about management of patients, it is crucial that the ISGPF classification system is merged with newer clinical data.

KW - Adenocarcinoma

KW - Adult

KW - Aged

KW - Aged, 80 and over

KW - Amylases

KW - Bile Duct Neoplasms

KW - Bilirubin

KW - C-Reactive Protein

KW - Decision Making

KW - Female

KW - Hospital Mortality

KW - Humans

KW - Logistic Models

KW - Male

KW - Middle Aged

KW - Multivariate Analysis

KW - Pancreatic Fistula

KW - Pancreaticoduodenectomy

KW - Pancreatitis, Chronic

U2 - 10.1097/SLA.0b013e31824f24e4

DO - 10.1097/SLA.0b013e31824f24e4

M3 - SCORING: Journal article

C2 - 22504279

VL - 256

SP - 130

EP - 138

JO - ANN SURG

JF - ANN SURG

SN - 0003-4932

IS - 1

ER -