Abstract
Background
Post-pancreatectomy acute pancreatitis (PPAP) is an increasingly described complication
after pancreatic resection. No uniform definition criteria were present in the literature
until the recent proposal of the International Study Group of Pancreatic Surgery (ISGPS).
Aim of this study is to evaluate the clinical significance of the novel ISGPS definition
of PPAP.
Methods
Patients who underwent pancreatoduodenectomy (PD) between 2006 and 2022 were enrolled.
PPAP was defined and graded according to the ISGPS criteria.
Results
Among 520 PDs, 120 (23%)patients developed post-operative hyperamylasemia (POH), while
PPAP occurred in 63(12.1%) cases. PPAP occurrence related to a higher rate of more
severe complications (48–76.1%vs118–25.8%; p < 0.0001), delayed gastric emptying (DGE)
(27–42.9%vd114–24.9%; p = 0.003) and post-operative pancreatic fistula (POPF) (57–90.5%vs186–40.8%;
p < 0.0001). When stratified for PPAP severity, grade B and C patients more frequently
developed major complications (p < 0.0001), POPF (p < 0.0001), DGE (p = 0.02) and
post-operative hemorrhage (p < 0.0001) as compared to POH. At the multivariable analysis,
soft pancreatic texture (p = 0.01)and a Wirsung diameter ≤3 mm (p = 0.01) were recognized
as prognostic factors for PPAP onset, while a pancreatic duct ≤3 mm was the only feature
significantly influencing a more severe course of PPAP (p = 0.01).
Conclusion
The ISGPS classification is confirmed as a valuable method for a uniform definition
and clinical course evaluation. Further studies in a prospective manner are still
needed for a further confirmation.
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Article info
Publication history
Published online: January 11, 2023
Accepted:
January 6,
2023
Received:
October 6,
2022
Footnotes
This paper was not based on a previous communication to a society or meeting.
Identification
Copyright
© 2023 International Hepato-Pancreato-Biliary Association Inc. Published by Elsevier Ltd. All rights reserved.
