TY - JOUR
T1 - Clinical and Financial Validation of the International Study Group for Pancreatic Surgery (ISGPS) Definition of Post-Pancreatectomy Acute Pancreatitis (PPAP)
T2 - International Multicenter Prospective Study
AU - Bannone, Elisa
AU - Cattelani, Alice
AU - Corvino, Gaetano
AU - Marchetti, Alessio
AU - Andreasi, Valentina
AU - Fermi, Francesca
AU - Partelli, Stefano
AU - Pecorelli, Nicolò
AU - Tamburrino, Domenico
AU - Esposito, Alessandro
AU - Malleo, Giuseppe
AU - Bhandare, Manish
AU - Gundavda, Kaival
AU - Jiang, Kuirong
AU - Lu, Zipeng
AU - Yin, Jie
AU - Lavu, Harish
AU - Klotz, Rosa
AU - Merz, Daniela
AU - Michalski, Christoph
AU - Klaiber, Ulla
AU - Montorsi, Marco
AU - Nappo, Gennaro
AU - Ikenaga, Naoki
AU - Scornamiglio, Pasquale
AU - Andersson, Bodil
AU - Jeffery, Fraser
AU - Halloran, Daniel
AU - Padbury, Robert
AU - Siriwardena, Ajith K.
AU - Barreto, Savio George
AU - Gianotti, Luca
AU - Oláh, Attila
AU - Halloran, Christopher M.
AU - Connor, Saxon
AU - Andersson, Roland
AU - Izbicki, Jakob R.
AU - Nakamura, Masafumi
AU - Zerbi, Alessandro
AU - Abu Hilal, Mohammad
AU - Loos, Martin
AU - Yeo, Charles J.
AU - Miao, Yi
AU - Falconi, Massimo
AU - Dervenis, Christos
AU - Neoptolemos, John P.
AU - Büchler, Markus W.
AU - Besselink, Marc G.
AU - Ferrone, Cristina
AU - Hackert, Thilo
AU - Salvia, Roberto
AU - Shrikhande, Shailesh V.
AU - Strobel, Oliver
AU - Werner, Jens
AU - Wolfgang, Christopher L.
AU - Marchegiani, Giovanni
AU - The International Study Group for Pancreatic Surgery (ISGPS)
AU - Adham, Mustapha
AU - Bockhorn, Maximillian
AU - Boggi, Ugo
AU - Busch, Olivier R.C.
AU - Butturini, Giovanni
AU - Conlon, Kevin Christopher
AU - Fingerhut, Abe
AU - Friess, Helmut
AU - Fusai, Giuseppe Kito
AU - Hartwig, Werner
AU - Kilburn, Daniel
AU - Lillemoe, Keith D.
AU - Manzoni, Alberto
AU - Radenkovic, Dejan
AU - Sarr, Michael
AU - Sato, Asahi
AU - Takaori, Kyoichi
AU - Vollmer, Charles
AU - Zyromski, Nicholas J.
PY - 2024/10/22
Y1 - 2024/10/22
N2 - Objective: To validate the ISGPS definition and grading system of PPAP after pancreatoduodenectomy (PD). Summary Background Data: In 2022, the International Study Group for Pancreatic Surgery (ISGPS) defined post-pancreatectomy acute pancreatitis (PPAP) and recommended a prospective validation of its diagnostic criteria and grading system. Methods: This was a prospective, international, multicenter study including patients undergoing PD at 17 referral pancreatic centers across Europe, Asia, Oceania, and the United States. PPAP diagnosis required the following three parameters: (1) postoperative serum hyperamylasemia /hyperlipasemia (POH) persisting on postoperative days 1 and 2, (2) radiologic alterations consistent with PPAP, and (3) a clinically relevant deterioration in the patient's condition. To validate the grading system, clinical and economic parameters were analyzed across all grades. Results: Among 2902 patients undergoing PD, 7.5% (n=218) developed PPAP (6.3% grade B and 1.2% grade C). POH occurred in 24.1% of patients. Hospital stay was associated with PPAP grades (No POH/PPAP 10 days (IQR 7-17) days, grade B 22 days (IQR 15-34) days, and grade C 43 days (IQR 27-54) days; P<0.001), as well as intensive care unit admission (No POH/PPAP 5.4%, grade B 12.6%, grade C 82.9%; P<0.010), and hospital readmission rates (No POH/PPAP 7.3%, grade B 16.1%, grade C 18.5%; P<0.05). Costs of grade B and C PPAP were 2 and 11 times greater than uncomplicated clinical course, resp. (P<0.001). Conclusions: This first prospective, international validation study of the ISGPS definition and grading system for PPAP highlighted the relevant clinical and financial implications of this condition. These results stress the importance of routine screening for PPAP in patients undergoing PD.
AB - Objective: To validate the ISGPS definition and grading system of PPAP after pancreatoduodenectomy (PD). Summary Background Data: In 2022, the International Study Group for Pancreatic Surgery (ISGPS) defined post-pancreatectomy acute pancreatitis (PPAP) and recommended a prospective validation of its diagnostic criteria and grading system. Methods: This was a prospective, international, multicenter study including patients undergoing PD at 17 referral pancreatic centers across Europe, Asia, Oceania, and the United States. PPAP diagnosis required the following three parameters: (1) postoperative serum hyperamylasemia /hyperlipasemia (POH) persisting on postoperative days 1 and 2, (2) radiologic alterations consistent with PPAP, and (3) a clinically relevant deterioration in the patient's condition. To validate the grading system, clinical and economic parameters were analyzed across all grades. Results: Among 2902 patients undergoing PD, 7.5% (n=218) developed PPAP (6.3% grade B and 1.2% grade C). POH occurred in 24.1% of patients. Hospital stay was associated with PPAP grades (No POH/PPAP 10 days (IQR 7-17) days, grade B 22 days (IQR 15-34) days, and grade C 43 days (IQR 27-54) days; P<0.001), as well as intensive care unit admission (No POH/PPAP 5.4%, grade B 12.6%, grade C 82.9%; P<0.010), and hospital readmission rates (No POH/PPAP 7.3%, grade B 16.1%, grade C 18.5%; P<0.05). Costs of grade B and C PPAP were 2 and 11 times greater than uncomplicated clinical course, resp. (P<0.001). Conclusions: This first prospective, international validation study of the ISGPS definition and grading system for PPAP highlighted the relevant clinical and financial implications of this condition. These results stress the importance of routine screening for PPAP in patients undergoing PD.
KW - health care costs
KW - pancreatic fistula
KW - pancreatitis
KW - pancreatoduodenectomy
KW - postoperative complications
KW - prospective studies
KW - validation studies
UR - http://www.scopus.com/inward/record.url?scp=85207888430&partnerID=8YFLogxK
U2 - 10.1097/SLA.0000000000006569
DO - 10.1097/SLA.0000000000006569
M3 - Article
C2 - 39435540
AN - SCOPUS:85207888430
SN - 0003-4932
JO - Annals of surgery
JF - Annals of surgery
ER -