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A Simple Classification Of Pancreatic Duct Size and Texture Predicts Postoperative Pancreatic Fistula

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A Simple Classification Of Pancreatic Duct Size and Texture Predicts Postoperative Pancreatic Fistula : A classification of the International Study Group of Pancreatic Surgery (ISGPS). / Schuh, Fabian; Mihaljevic, André L; Probst, Pascal; Trudeau, Maxwell T; Müller, Philip C; Marchegiani, Giovanni; Besselink, Marc G; Uzunoglu, Faik; Izbicki, Jakob R; Falconi, Massimo; Fernandez-Del Castillo, Carlos; Adham, Mustapha; Z'graggen, Kaspar; Friess, Helmut; Werner, Jens; Weitz, Jürgen; Strobel, Oliver; Hackert, Thilo; Radenkovic, Dejan; Kelemen, Dezső; Wolfgang, Christopher; Miao, Y I; Shrikhande, Shailesh V; Lillemoe, Keith D; Dervenis, Christos; Bassi, Claudio; Neoptolemos, John P; Diener, Markus K; Vollmer, Charles M; Büchler, Markus W.

In: ANN SURG, Vol. 277, No. 3, 01.03.2023, p. e597-e608.

Research output: SCORING: Contribution to journal › SCORING: Journal article › Research › peer-review

Harvard

Schuh, F, Mihaljevic, AL, Probst, P, Trudeau, MT, Müller, PC, Marchegiani, G, Besselink, MG, Uzunoglu, F, Izbicki, JR, Falconi, M, Fernandez-Del Castillo, C, Adham, M, Z'graggen, K, Friess, H, Werner, J, Weitz, J, Strobel, O, Hackert, T, Radenkovic, D, Kelemen, D, Wolfgang, C, Miao, YI, Shrikhande, SV, Lillemoe, KD, Dervenis, C, Bassi, C, Neoptolemos, JP, Diener, MK, Vollmer, CM & Büchler, MW 2023, 'A Simple Classification Of Pancreatic Duct Size and Texture Predicts Postoperative Pancreatic Fistula: A classification of the International Study Group of Pancreatic Surgery (ISGPS)', ANN SURG, vol. 277, no. 3, pp. e597-e608. https://doi.org/10.1097/SLA.0000000000004855

APA

Schuh, F., Mihaljevic, A. L., Probst, P., Trudeau, M. T., Müller, P. C., Marchegiani, G., Besselink, M. G., Uzunoglu, F., Izbicki, J. R., Falconi, M., Fernandez-Del Castillo, C., Adham, M., Z'graggen, K., Friess, H., Werner, J., Weitz, J., Strobel, O., Hackert, T., Radenkovic, D., ... Büchler, M. W. (2023). A Simple Classification Of Pancreatic Duct Size and Texture Predicts Postoperative Pancreatic Fistula: A classification of the International Study Group of Pancreatic Surgery (ISGPS). ANN SURG, 277(3), e597-e608. https://doi.org/10.1097/SLA.0000000000004855

Vancouver

Schuh F, Mihaljevic AL, Probst P, Trudeau MT, Müller PC, Marchegiani G et al. A Simple Classification Of Pancreatic Duct Size and Texture Predicts Postoperative Pancreatic Fistula: A classification of the International Study Group of Pancreatic Surgery (ISGPS). ANN SURG. 2023 Mar 1;277(3):e597-e608. https://doi.org/10.1097/SLA.0000000000004855

Bibtex

@article{8b40f5ba4cdc4dd8b16634c302e4596c,
title = "A Simple Classification Of Pancreatic Duct Size and Texture Predicts Postoperative Pancreatic Fistula: A classification of the International Study Group of Pancreatic Surgery (ISGPS)",
abstract = "OBJECTIVE: The aim of this study was to develop a classification system for pancreas-associated risk factors in pancreatoduodenectomy (PD).SUMMARY BACKGROUND DATA: Postoperative pancreatic fistula (POPF) is the most relevant PD-associated complication. A simple standardized surgical reporting system based on pancreas-associated risk factors is lacking.METHODS: A systematic literature search was conducted to identify studies investigating clinically relevant (CR) POPF (CR-POPF) and pancreas-associated risk factors after PD. A meta-analysis of CR-POPF rate for texture of the pancreas (soft vs not-soft) and main pancreatic duct (MPD) diameter was performed using the Mantel-Haenszel method. Based on the results, the International Study Group of Pancreatic Surgery (ISGPS) proposes the following classification: A, not-soft (hard) texture and MPD >3 mm; B, not-soft (hard) texture and MPD ≤3 mm; C, soft texture and MPD >3 mm; D, soft texture and MPD ≤3 mm. The classification was evaluated in a multi-institutional, international cohort.RESULTS: Of the 2917 articles identified, 108 studies were included in the analyses. Soft pancreatic texture was significantly associated with the development of CR-POPF [odds ratio (OR) 4.24, 95% confidence interval (CI) 3.67-4.89, P < 0.01) following PD. Similarly, MPD diameter ≤3 mm significantly increased CR-POPF risk compared with >3 mm diameter MPDs (OR 3.66, 95% CI 2.62-5.12, P < 0.01). The proposed 4-stage system was confirmed in an independent cohort of 5533 patients with CR-POPF rates of 3.5%, 6.2%, 16.6%, and 23.2% for type A-D, respectively ( P < 0.001).CONCLUSION: For future pancreatic surgical outcomes studies, the ISGPS recommends reporting these risk factors according to the proposed classification system for better comparability of results.",
author = "Fabian Schuh and Mihaljevic, {Andr{\'e} L} and Pascal Probst and Trudeau, {Maxwell T} and M{\"u}ller, {Philip C} and Giovanni Marchegiani and Besselink, {Marc G} and Faik Uzunoglu and Izbicki, {Jakob R} and Massimo Falconi and {Fernandez-Del Castillo}, Carlos and Mustapha Adham and Kaspar Z'graggen and Helmut Friess and Jens Werner and J{\"u}rgen Weitz and Oliver Strobel and Thilo Hackert and Dejan Radenkovic and Dezs{\H o} Kelemen and Christopher Wolfgang and Miao, {Y I} and Shrikhande, {Shailesh V} and Lillemoe, {Keith D} and Christos Dervenis and Claudio Bassi and Neoptolemos, {John P} and Diener, {Markus K} and Vollmer, {Charles M} and B{\"u}chler, {Markus W}",
year = "2023",
month = mar,
day = "1",
doi = "10.1097/SLA.0000000000004855",
language = "English",
volume = "277",
pages = "e597--e608",
journal = "ANN SURG",
issn = "0003-4932",
publisher = "Lippincott Williams and Wilkins",
number = "3",

}

RIS

TY - JOUR

T1 - A Simple Classification Of Pancreatic Duct Size and Texture Predicts Postoperative Pancreatic Fistula

T2 - A classification of the International Study Group of Pancreatic Surgery (ISGPS)

AU - Schuh, Fabian

AU - Mihaljevic, André L

AU - Probst, Pascal

AU - Trudeau, Maxwell T

AU - Müller, Philip C

AU - Marchegiani, Giovanni

AU - Besselink, Marc G

AU - Uzunoglu, Faik

AU - Izbicki, Jakob R

AU - Falconi, Massimo

AU - Fernandez-Del Castillo, Carlos

AU - Adham, Mustapha

AU - Z'graggen, Kaspar

AU - Friess, Helmut

AU - Werner, Jens

AU - Weitz, Jürgen

AU - Strobel, Oliver

AU - Hackert, Thilo

AU - Radenkovic, Dejan

AU - Kelemen, Dezső

AU - Wolfgang, Christopher

AU - Miao, Y I

AU - Shrikhande, Shailesh V

AU - Lillemoe, Keith D

AU - Dervenis, Christos

AU - Bassi, Claudio

AU - Neoptolemos, John P

AU - Diener, Markus K

AU - Vollmer, Charles M

AU - Büchler, Markus W

PY - 2023/3/1

Y1 - 2023/3/1

N2 - OBJECTIVE: The aim of this study was to develop a classification system for pancreas-associated risk factors in pancreatoduodenectomy (PD).SUMMARY BACKGROUND DATA: Postoperative pancreatic fistula (POPF) is the most relevant PD-associated complication. A simple standardized surgical reporting system based on pancreas-associated risk factors is lacking.METHODS: A systematic literature search was conducted to identify studies investigating clinically relevant (CR) POPF (CR-POPF) and pancreas-associated risk factors after PD. A meta-analysis of CR-POPF rate for texture of the pancreas (soft vs not-soft) and main pancreatic duct (MPD) diameter was performed using the Mantel-Haenszel method. Based on the results, the International Study Group of Pancreatic Surgery (ISGPS) proposes the following classification: A, not-soft (hard) texture and MPD >3 mm; B, not-soft (hard) texture and MPD ≤3 mm; C, soft texture and MPD >3 mm; D, soft texture and MPD ≤3 mm. The classification was evaluated in a multi-institutional, international cohort.RESULTS: Of the 2917 articles identified, 108 studies were included in the analyses. Soft pancreatic texture was significantly associated with the development of CR-POPF [odds ratio (OR) 4.24, 95% confidence interval (CI) 3.67-4.89, P < 0.01) following PD. Similarly, MPD diameter ≤3 mm significantly increased CR-POPF risk compared with >3 mm diameter MPDs (OR 3.66, 95% CI 2.62-5.12, P < 0.01). The proposed 4-stage system was confirmed in an independent cohort of 5533 patients with CR-POPF rates of 3.5%, 6.2%, 16.6%, and 23.2% for type A-D, respectively ( P < 0.001).CONCLUSION: For future pancreatic surgical outcomes studies, the ISGPS recommends reporting these risk factors according to the proposed classification system for better comparability of results.

AB - OBJECTIVE: The aim of this study was to develop a classification system for pancreas-associated risk factors in pancreatoduodenectomy (PD).SUMMARY BACKGROUND DATA: Postoperative pancreatic fistula (POPF) is the most relevant PD-associated complication. A simple standardized surgical reporting system based on pancreas-associated risk factors is lacking.METHODS: A systematic literature search was conducted to identify studies investigating clinically relevant (CR) POPF (CR-POPF) and pancreas-associated risk factors after PD. A meta-analysis of CR-POPF rate for texture of the pancreas (soft vs not-soft) and main pancreatic duct (MPD) diameter was performed using the Mantel-Haenszel method. Based on the results, the International Study Group of Pancreatic Surgery (ISGPS) proposes the following classification: A, not-soft (hard) texture and MPD >3 mm; B, not-soft (hard) texture and MPD ≤3 mm; C, soft texture and MPD >3 mm; D, soft texture and MPD ≤3 mm. The classification was evaluated in a multi-institutional, international cohort.RESULTS: Of the 2917 articles identified, 108 studies were included in the analyses. Soft pancreatic texture was significantly associated with the development of CR-POPF [odds ratio (OR) 4.24, 95% confidence interval (CI) 3.67-4.89, P < 0.01) following PD. Similarly, MPD diameter ≤3 mm significantly increased CR-POPF risk compared with >3 mm diameter MPDs (OR 3.66, 95% CI 2.62-5.12, P < 0.01). The proposed 4-stage system was confirmed in an independent cohort of 5533 patients with CR-POPF rates of 3.5%, 6.2%, 16.6%, and 23.2% for type A-D, respectively ( P < 0.001).CONCLUSION: For future pancreatic surgical outcomes studies, the ISGPS recommends reporting these risk factors according to the proposed classification system for better comparability of results.

U2 - 10.1097/SLA.0000000000004855

DO - 10.1097/SLA.0000000000004855

M3 - SCORING: Journal article

C2 - 33914473

VL - 277

SP - e597-e608

JO - ANN SURG

JF - ANN SURG

SN - 0003-4932

IS - 3

ER -