Postoperative Pancreatic Fistula: An International Study Group (ISG) Definition Compared to Clinically Usable Definition
Introduction: Postoperative pancreatic fistula (POPF) has been regarded traditionally as the most frequent major complication and is a potentially serious, life-threatening event that may prolong hospital stay and increase costs. After pancreatoduodenectomy, the reported rate of POPF is highly variable, ranging from 2% to more than 20%. These differences might be related to the variability of the definitions used. The International Study Group (ISG) developed definition of POPF, graded primarily on clinical impact. Therefore the aim of our study was to compare clinical impact of two definitions of POPF (ISG definition and definition used previously). Methods: Clinical data was prospectively collected from 29 patients undergoing Whipple resection (5 patients), pylorus preserving pancreatoduodenectomy (22 patients) and distal pancreatectomy (2 patients). Level of amylase in serum and in drainage fluid was measured on postoperative day 1, 3 and 7. If there was a suspicion of pancreatic fistula an X-ray examination (fistulography) was performed. Pancreatic fistula was defined either when amylase rich [...].