Postoperative pancreatic fistula: Low preoperative ejection fraction may be another contributing factor


ÜSTÜNER M. A., Piskin E., Ozgun Y. M., Erkan E. S., AKSOY E., BOSTANCI E. B.

Kuwait Medical Journal, cilt.54, sa.3, ss.320-326, 2022 (SCI-Expanded, Scopus)

  • Yayın Türü: Makale / Tam Makale
  • Cilt numarası: 54 Sayı: 3
  • Basım Tarihi: 2022
  • Dergi Adı: Kuwait Medical Journal
  • Derginin Tarandığı İndeksler: Science Citation Index Expanded (SCI-EXPANDED), Scopus, EMBASE
  • Sayfa Sayıları: ss.320-326
  • Anahtar Kelimeler: ejection fraction, pancreaticoduodenectomy, postoperative pancreatic fistula
  • Sağlık Bilimleri Üniversitesi Adresli: Evet

Özet

Objective: We investigated if ejection fraction (EF) was a predisposing factor for postoperative pancreatic fistula (POPF) as a perfusion indicator, or not. Design: This was a retrospective single center study. Setting: Türkiye Yüksek İhtisas Training and Research Hospital, Clinic of Gastroenterologic Surgery, Ankara, Turkey Subjects: A total of 77 patients who underwent pancreaticoduodenectomy Intervention: EF values were divided into three groups with demographic similarity as 40-49, 50-59, and 60 and above. The relationship between EF and POPF was investigated. Main outcome measures: Preoperative EF, albumin, bilirubin, hemoglobin, C-reactive protein, white blood cells, neutrophil, lymphocyte, aspartate aminotransferase, alanine transaminase, gamma glutamyl transferase, carcinoembryonic antigen, CA19-9 values; intraoperative data such as operation type, ductus diameter in pancreas after resection, the presence of porta resection; postoperative pathology results, fistula grades, and 1st and 3rd day drain and blood amylases were retrospectively recorded. Results: EF value was found to be between 40-49 in 10 (13%) patients, between 50-59 in 37 (48%) patients, and 60 or above in 30 (39%) patients. EF values of cases with leakage were found to be statistically significantly lower than the cases without leakage (P <0,05). In case of leakage, optimal cut-off value was calculated as ≤52. Conclusion: EF values of cases with leakage in pancreas fistulas were found to be statistically significantly lower than the cases without leakage (P <0.05). Cut-off value was found as 52 (area under curve, with 93% interval of confidence). EF value below 52 in patients who underwent pancreaticoduodenectomy statistically increases pancreatic fistulas.