Department of Surgery, Second Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, Zhejiang, People's Republic of China.
Pancreas. 2011 Mar;40(2):222-8. doi: 10.1097/MPA.0b013e3181f82f3c.
The purposes of this study were to validate the value of the International Study Group on Pancreatic Fistula (ISGPF) classification scheme for pancreatic fistula (PF) and to identify predictive factors for clinically significant PF.
From January 2000 to December 2007, 294 consecutive patients underwent pancreaticoduodenectomy in a single medical center. Pancreatic fistula was evaluated by the ISGPF criteria and Johns Hopkins Hospital's definition (JHH). Then, logistic regression analysis was performed to identify predictive factors for PF development. Our own management strategies with PF were also discussed.
The overall incidence of PF was 19.4% (57/294) according to the ISGPF criteria, and 8.8% (26/294) using the JHH definition. Thirty-one patients with PF classified by the ISGPF were missed by the JHH definition. By logistic regression analysis, we found that besides the lack of cardiovascular disease and malignant diseases, our single-layer continuous circular invaginated pancreaticojejunostomy was another independent factor for the lowered incidence of PF.
The ISGPF classification scheme was accurate for evaluating PF. Single-layer continuous circular invaginated pancreaticojejunostomy may be a promising method that may have been responsible for the lower incidence of PF in this study.
本研究旨在验证国际胰腺瘘研究组（ISGPF）胰腺瘘（PF）分类方案的价值，并确定预测临床显著 PF 的因素。
2000 年 1 月至 2007 年 12 月，在一家医疗中心连续对 294 例患者进行胰十二指肠切除术。根据 ISGPF 标准和约翰霍普金斯医院的定义（JHH）评估胰腺瘘。然后，进行逻辑回归分析以确定 PF 发生的预测因素。还讨论了我们自己对 PF 的管理策略。
根据 ISGPF 标准，PF 的总发生率为 19.4%（57/294），根据 JHH 定义为 8.8%（26/294）。JHH 定义漏诊了 ISGPF 分类的 31 例 PF 患者。通过逻辑回归分析，我们发现，除了没有心血管疾病和恶性疾病外，我们的单层连续圆形内陷式胰肠吻合术也是 PF 发生率降低的另一个独立因素。
ISGPF 分类方案可准确评估 PF。单层连续圆形内陷式胰肠吻合术可能是一种有前途的方法，这可能是本研究中 PF 发生率较低的原因。
