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World J Gastroenterol. Dec 14, 2013; 19(46): 8696-8702
Published online Dec 14, 2013. doi: 10.3748/wjg.v19.i46.8696
Published online Dec 14, 2013. doi: 10.3748/wjg.v19.i46.8696
Risk factors to predict severe postoperative pancreatic fistula following gastrectomy for gastric cancer
Shuhei Komatsu, Daisuke Ichikawa, Kingo Kashimoto, Takeshi Kubota, Kazuma Okamoto, Hirotaka Konishi, Atsushi Shiozaki, Hitoshi Fujiwara, Eigo Otsuji, Division of Digestive Surgery, Department of Surgery, Kyoto Prefectural University of Medicine, Kyoto 602-8566, Japan
Author contributions: Komatsu S, Ichikawa D, Kashimoto K, Kubota T, Okamoto K, Konishi H, Shiozaki A, Fujiwara H and Otsuji E performed research; Komatsu S and Kashimoto K analyzed the data; Komatsu S wrote the paper.
Correspondence to: Shuhei Komatsu, MD, Division of Digestive Surgery, Department of Surgery, Kyoto Prefectural University of Medicine, 465 Kajii-cho, Kawaramachihirokoji, Kamigyo-ku, Kyoto 602-8566, Japan. skomatsu@koto.kpu-m.ac.jp
Telephone: +81-75-2515527 Fax: +81-75-2515522
Received: June 2, 2013
Revised: September 17, 2013
Accepted: September 29, 2013
Published online: December 14, 2013
Revised: September 17, 2013
Accepted: September 29, 2013
Published online: December 14, 2013
Core Tip
Core tip: Although several possible risk factors associated with the occurrence of postoperative pancreatic fistula (POPF) have been reported, there have been no generally accepted risk factors to predict POPF changing into extremely severe POPF. In this study, we demonstrated that older patients (P = 0.035) and those with lower lymphocyte counts at the diagnosis of POPF (P = 0.007) were significantly associated with extremely severe International Study Group on Pancreatic Fistula grade C POPF, and a low lymphocyte count was identified as an independent risk factor by multivariate analysis (P = 0.045, OR = 10.45).