PMID- 22526042
OWN - NLM
STAT- MEDLINE
DCOM- 20121002
LR  - 20211021
IS  - 1432-2323 (Electronic)
IS  - 0364-2313 (Print)
IS  - 0364-2313 (Linking)
VI  - 36
IP  - 7
DP  - 2012 Jul
TI  - Rate of clinically significant postoperative pancreatic fistula in pancreatic 
      neuroendocrine tumors.
PG  - 1517-26
LID - 10.1007/s00268-012-1598-9 [doi]
AB  - BACKGROUND: In 2005, the International Study Group of Pancreatic Fistula (ISGPF) 
      developed a definition and grading system for postoperative pancreatic fistula 
      (POPF). The authors sought to determine the rate of POPF after enucleation and/or 
      resection of pancreatic neuroendocrine tumors (PNET) and to identify clinical, 
      surgical, or pathologic factors associated with POPF. METHODS: A retrospective 
      analysis of pancreatic enucleations and resections performed from March 1998 to 
      April 2010. We defined a clinically significant POPF as a grade B that required 
      nonoperative intervention and grade C. RESULTS: One hundred twenty-two patients 
      were identified; 62 patients had enucleations and 60 patients had resections of 
      PNET. The rate of clinically significant POPF was 23.7 % (29/122). For pancreatic 
      enucleation, the POPF rate was 27.4 % (17/62, 14 grade B, 3 grade C). The 
      pancreatic resection group had a POPF rate of 20 % (12/60, 10 grade B, 2 grade 
      C). This difference was not significant (p = 0.4). In univariate analyses, 
      patients in the enucleation group with hereditary syndromes (p = 0.02) and 
      non-insulinoma tumors (p = 0.02) had a higher POPF rate. Patients in the 
      resection group with body mass index (BMI) > 25 (p < 0.01), multiple endocrine 
      neoplasia type 1 (MEN-1; p < 0.01) and those who underwent simultaneous multiple 
      procedures (p = 0.02) had a higher POPF rate. Multivariate analyses revealed that 
      hereditary syndromes were able to predict POPF in the enucleation group, while 
      having BMI > 25 and increasing lesion size were also associated with POPF in the 
      group undergoing resection. CONCLUSIONS: We found a clinically significant POPF 
      rate after surgery in PNET to be 23.7 % with no difference by the type of 
      operation. Our POPF rate is comparable to that reported in the literature for 
      pancreatic resection for other types of tumors. Certain inherited genetic 
      diseases-von Hippel-Lindau disease (VHL) and MEN-1-were associated with higher 
      POPF rates.
FAU - Inchauste, Suzanne M
AU  - Inchauste SM
AD  - Endocrine Oncology Section, Surgery Branch, Center for Cancer Research, National 
      Cancer Institute, 10 Center Drive, MSC1201 Rm 4W-5940, Bethesda, MD 20892-1201, 
      USA.
FAU - Lanier, Brock J
AU  - Lanier BJ
FAU - Libutti, Steven K
AU  - Libutti SK
FAU - Phan, Giao Q
AU  - Phan GQ
FAU - Nilubol, Naris
AU  - Nilubol N
FAU - Steinberg, Seth M
AU  - Steinberg SM
FAU - Kebebew, Electron
AU  - Kebebew E
FAU - Hughes, Marybeth S
AU  - Hughes MS
LA  - eng
GR  - Z99 CA999999/Intramural NIH HHS/United States
PT  - Journal Article
PL  - United States
TA  - World J Surg
JT  - World journal of surgery
JID - 7704052
SB  - IM
MH  - Adult
MH  - Body Mass Index
MH  - Female
MH  - Humans
MH  - Laparoscopy
MH  - Male
MH  - Middle Aged
MH  - Neuroendocrine Tumors/genetics/*surgery
MH  - Pancreatectomy
MH  - Pancreatic Fistula/*etiology
MH  - Pancreatic Neoplasms/genetics/*surgery
MH  - Pancreaticoduodenectomy
MH  - *Postoperative Complications
MH  - Retrospective Studies
MH  - Treatment Outcome
PMC - PMC3521612
MID - NIHMS419030
EDAT- 2012/04/25 06:00
MHDA- 2012/10/04 06:00
PMCR- 2012/12/13
CRDT- 2012/04/25 06:00
PHST- 2012/04/25 06:00 [entrez]
PHST- 2012/04/25 06:00 [pubmed]
PHST- 2012/10/04 06:00 [medline]
PHST- 2012/12/13 00:00 [pmc-release]
AID - 10.1007/s00268-012-1598-9 [doi]
PST - ppublish
SO  - World J Surg. 2012 Jul;36(7):1517-26. doi: 10.1007/s00268-012-1598-9.