Details

Autor(en) / Beteiligte

• Gangl, Odo
• Fröschl, Uwe
• Hofer, Wolfgang
• Huber, Jürgen
• Sautner, Thomas
• Függer, Reinhold

Titel

Unplanned Reoperation and Reintervention after Pancreatic Resections: An Analysis of Risk Factors

Ist Teil von

• World journal of surgery, 2011-10, Vol.35 (10), p.2306-2314

Ort / Verlag

New York: Springer-Verlag

Erscheinungsjahr

2011

Link zum Volltext

Quelle

Wiley-Blackwell Journals

Beschreibungen/Notizen

• Background The purpose of the study was to determine the incidence of any unplanned reoperation or reintervention procedure after pancreatic resection and to identify the underlying risk factors. Methods A total of 189 consecutive pancreatic resections performed from 2001–2008 were searched for any unplanned reoperation, percutaneous drainage, or angiographic reintervention. A retrospective analysis of a prospectively maintained database, including patient characteristics, comorbidities, details of surgery, specific complications, incidence of reoperation/reintervention, and mortality was performed. Results Overall rates of reoperation, reintervention, and mortality were 6.3% (12/189), 7.9% (15/189), and 1.6% (3/189), respectively. Four patients underwent reintervention and reoperation, so the combined reoperation/reintervention rate was 12.2% (23/189). Reoperation ( P  < 0.001) and reintervention ( P  = 0.002) correlated with mortality. Hemorrhage (relative risk [RR], 58; P  = 0.0017) and the combination of hemorrhage and pancreatic fistula (RR, 117; P  < 0.0001) were identified as risk factors for unplanned reoperation, hemorrhage (RR, 82; P  = 0.005), pancreatic fistula (RR, 42; P  < 0.001), and the combination of both complications (RR, 246; P  < 0.001) for reoperation and/or reintervention. Other patient- or procedure-related factors did not influence the reoperation and/or reintervention rates significantly. Conclusions Pancreatic fistula and hemorrhage are the predominant factors that afford unplanned reoperation/reintervention. Although reporting the incidence of unplanned reoperation will include the most severe postoperative complications, a considerable number of reinterventions are missed. Therefore, in outcome analyses of pancreatic surgery, not only reoperations but also any interventional therapies should be included.