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©2008 The WJG Press and Baishideng.
World J Gastroenterol. Oct 14, 2008; 14(38): 5789-5796
Published online Oct 14, 2008. doi: 10.3748/wjg.14.5789
Published online Oct 14, 2008. doi: 10.3748/wjg.14.5789
Table 1 The different components of previously used definitions of pancreatic fistula and the new grading system used by the International Study Group for Pancreatic Fistula (ISGPF)
Commonly used definitions used prior to the ISGPF recommendations | ||||
Output > 10 mL/d of amylase rich fluid on post-operative day 5 or for > 5 d. | ||||
Output > 10 mL/d of amylase rich fluid on post-operative day 8 or for > 8 d. | ||||
Output between 25 mL/d and 100 mL/d of amylase rich fluid after post-operative day 8 or for > 8 d. | ||||
Output > 50 mL/d of amylase rich fluid after post-operative day 11 or for > 11 d. | ||||
ISGPF Definition: “Output via an operatively placed drain (or a subsequently placed percutaneous drain) of any measurable volume of drain fluid on or after postoperative d 3, with an amylase content greater than 3 times the upper normal serum value” | ||||
Grade A | “Transient fistula” | No clinical impact | No peri-pancreatic collections on CT scan; little/no change in management | Clinically well; no sepsis; no prolongation of hospital stay; slow removal of operatively placed drains |
Grade B | Clinical impact | Peri-pancreatic drains in place or repositioned to drain collections; Change in management is required | Clinically fairly well; degree of infection requiring specific treatment; prolongation of hospital stay; patients often discharged with drains in situ and observed in outpatient setting | |
Grade C | Severe clinical impact | Worrisome peri-pancreatic collections that require percutaneous drains; major change in management usually in ICU setting; possible re-surgery to salvage a difficult situation (completion pancreatectomy etc) | Clinically unwell; associated sepsis requiring aggressive antibiotics, octreotide and other intensive care support; major prolongation of hospital stay; associated complications and possibility of mortality |
- Citation: Shrikhande SV, D’Souza MA. Pancreatic fistula after pancreatectomy: Evolving definitions, preventive strategies and modern management. World J Gastroenterol 2008; 14(38): 5789-5796
- URL: https://www.wjgnet.com/1007-9327/full/v14/i38/5789.htm
- DOI: https://dx.doi.org/10.3748/wjg.14.5789