Risk factors of serious postoperative complications after pancreaticoduodenectomy and risk calculators for predicting postoperative complications: a nationwide study of 17,564 patients in Japan

Shuichi Aoki, Hiroaki Miyata, Hiroyuki Konno, Mitsukazu Gotoh, Fuyuhiko Motoi, Hiraku Kumamaru, Go Wakabayashi, Yoshihiro Kakeji, Masaki Mori, Yasuyuki Seto, Michiaki Unno

Research output: Contribution to journalArticle

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Abstract

Background: The morbidity rate after pancreaticoduodenectomy remains high. The objectives of this retrospective cohort study were to clarify the risk factors associated with serious morbidity (Clavien–Dindo classification grades IV–V), and create complication risk calculators using the Japanese National Clinical Database. Methods: Between 2011 and 2012, data from 17,564 patients who underwent pancreaticoduodenectomy at 1,311 institutions in Japan were recorded in this database. The morbidity rate and associated risk factors were analyzed. Results: The overall and serious morbidity rates were 41.6% and 4.5%, respectively. A pancreatic fistula (PF) with an International Study Group of Pancreatic Fistula (ISGPF) grade C was significantly associated with serious morbidity (P < 0.001). Twenty-one variables were considered statistically significant predictors of serious complications, and 15 of them overlapped with those of a PF with ISGPF grade C. The predictors included age, sex, obesity, functional status, smoking status, the presence of a comorbidity, non-pancreatic cancer, combined vascular resection, and several abnormal laboratory results. C-indices of the risk models for serious morbidity and grade C PF were 0.708 and 0.700, respectively. Conclusions: Preventing a PF grade C is important for decreasing the serious morbidity rate and these risk calculations contribute to adequate patient selection.

Original languageEnglish
Pages (from-to)243-251
Number of pages9
JournalJournal of Hepato-Biliary-Pancreatic Sciences
Volume24
Issue number5
DOIs
Publication statusPublished - May 1 2017

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Pancreaticoduodenectomy
Pancreatic Fistula
Japan
Morbidity
Databases
Patient Selection
Blood Vessels
Comorbidity
Cohort Studies
Retrospective Studies
Obesity
Smoking

All Science Journal Classification (ASJC) codes

  • Surgery
  • Hepatology

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Risk factors of serious postoperative complications after pancreaticoduodenectomy and risk calculators for predicting postoperative complications : a nationwide study of 17,564 patients in Japan. / Aoki, Shuichi; Miyata, Hiroaki; Konno, Hiroyuki; Gotoh, Mitsukazu; Motoi, Fuyuhiko; Kumamaru, Hiraku; Wakabayashi, Go; Kakeji, Yoshihiro; Mori, Masaki; Seto, Yasuyuki; Unno, Michiaki.

In: Journal of Hepato-Biliary-Pancreatic Sciences, Vol. 24, No. 5, 01.05.2017, p. 243-251.

Research output: Contribution to journalArticle

Aoki, Shuichi ; Miyata, Hiroaki ; Konno, Hiroyuki ; Gotoh, Mitsukazu ; Motoi, Fuyuhiko ; Kumamaru, Hiraku ; Wakabayashi, Go ; Kakeji, Yoshihiro ; Mori, Masaki ; Seto, Yasuyuki ; Unno, Michiaki. / Risk factors of serious postoperative complications after pancreaticoduodenectomy and risk calculators for predicting postoperative complications : a nationwide study of 17,564 patients in Japan. In: Journal of Hepato-Biliary-Pancreatic Sciences. 2017 ; Vol. 24, No. 5. pp. 243-251.
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AU - Gotoh, Mitsukazu

AU - Motoi, Fuyuhiko

AU - Kumamaru, Hiraku

AU - Wakabayashi, Go

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