Casadei Riccardo, Ricci Claudio, Pezzilli Raffaele, Calculli Lucia, D'Ambra Marielda, Taffurelli Giovanni, Minni Francesco
Department of Surgery, Alma Mater Studiorum - University of di Bologna, S.Orsola-Malpighi Hospital. Bologna, Italy.
JOP. 2011 Mar 9;12(2):126-30.
The absence of a definition and a widely accepted ranking system to classify surgical complications has hampered proper interpretation of the surgical outcome.
Sixty-one patients undergoing distal pancreatectomy.
The complications were classified according to the Clavien-Dindo classification; each grade was evaluated regarding the length of the postoperative stay and was compared to the most important complications.
Thirty (49.2%) patients had no complications; out of the thirty-one (50.8%) patients with complications, 9 (14.5%) had grade I, 15 (24.6%) had grade II, 6 (9.8%) had grade III, and 1 (1.6%) had grade IV. There were no postoperative deaths (grade V). A progressive increase in the length of hospitalization from patients with no complications to those having grade IV (P < 0.001) was noted. Postoperative pancreatic fistula and postpancreatectomy hemorrhage rates did not significantly increase from Clavien-Dindo grade I to grade IV (P = 0.118 and P = 0.226, respectively). The severity of a postpancreatectomy hemorrhage, instead, was positively related to the grade of the Clavien-Dindo classification (P = 0.049) while postoperative pancreatic fistula resulted near the significant value (P = 0.058).
The Clavien-Dindo classification is a simple way of reporting all complications following distal pancreatectomy. It allows us to distinguish a normal postoperative course from any deviation and the severity of complications and it may be useful for comparing postoperative morbidity between different pancreatic centers.
缺乏对外科手术并发症进行分类的定义和广泛接受的分级系统，阻碍了对手术结果的正确解读。
61例行胰体尾切除术的患者。
并发症按照Clavien-Dindo分级系统进行分类；评估各分级的术后住院时间，并与最重要的并发症进行比较。
30例（49.2%）患者无并发症；在31例（50.8%）有并发症的患者中，9例（14.5%）为Ⅰ级，15例（24.6%）为Ⅱ级，6例（9.8%）为Ⅲ级，1例（1.6%）为Ⅳ级。无术后死亡（Ⅴ级）病例。观察到从无并发症患者到Ⅳ级患者，住院时间呈逐渐增加趋势（P<0.001）。从Clavien-DindoⅠ级到Ⅳ级，术后胰瘘和胰体尾切除术后出血发生率未显著增加（分别为P = 0.118和P = 0.226）。相反，胰体尾切除术后出血的严重程度与Clavien-Dindo分级呈正相关（P = 0.049），而术后胰瘘接近显著值（P = 0.058）。
Clavien-Dindo分级是报告胰体尾切除术后所有并发症的一种简单方法。它使我们能够区分正常的术后过程与任何偏差以及并发症的严重程度，并且可能有助于比较不同胰腺中心之间的术后发病率。
