Document Detail


Risk factors for pancreas-related abscess after total gastrectomy.
MedLine Citation:
PMID:  16086115     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: European clinical trials of gastrectomy have shown that pancreas-related complications are the major cause of mortality. The aim of this study was to determine the risk factors for pancreas-related abscess after gastrectomy and to evaluate the effects of the abscess on postoperative mortality. METHODS: Between 1992 and 1999, 663 consecutive patients with gastric carcinoma underwent total gastrectomy. Data from these patients were analyzed, to identify the predictors of pancreas-related abscess caused by pancreatic juice leakage, by a multiple logistic regression model. RESULTS: On multivariate analysis, increasing age (P = 0.018) and body mass index (P = 0.006) were independent preoperative risk factors. Dissection along the distal splenic artery was an intraoperative risk factor. The hazard ratios were increased 9.13-fold (P = 0.000) with a pancreas-preserving operation and 16.72-fold (P = 0.000) by distal pancreatectomy. Patients with the abscess had a higher postoperative mortality rate (P = 0.008), and a higher re-operation rate (P < 0.001) than patients without the abscess. CONCLUSION: Pancreas-related abscess is more likely to occur in older, obese patients undergoing node dissection along the distal splenic artery. Abscess formation is associated with a higher mortality and re-operation rate. Spleen preservation should be evaluated in Japan.
Authors:
Hitoshi Katai; Kimio Yoshimura; Takeo Fukagawa; Takeshi Sano; Mitsuru Sasako
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Gastric cancer : official journal of the International Gastric Cancer Association and the Japanese Gastric Cancer Association     Volume:  8     ISSN:  1436-3291     ISO Abbreviation:  Gastric Cancer     Publication Date:  2005  
Date Detail:
Created Date:  2005-08-08     Completed Date:  2005-11-22     Revised Date:  2007-01-08    
Medline Journal Info:
Nlm Unique ID:  100886238     Medline TA:  Gastric Cancer     Country:  Japan    
Other Details:
Languages:  eng     Pagination:  137-41     Citation Subset:  IM    
Affiliation:
Department of Surgical Oncology, National Cancer Center Hospital, 5-1-1 Tsukiji, Chuo-ku, Tokyo 104-0045, Japan.
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MeSH Terms
Descriptor/Qualifier:
Abscess / etiology*,  mortality
Adult
Aged
Aged, 80 and over
Female
Gastrectomy / adverse effects*
Humans
Japan / epidemiology
Male
Middle Aged
Pancreatic Diseases / etiology*,  mortality
Postoperative Complications*
Risk Factors
Splenectomy
Stomach Neoplasms / surgery
Survival Rate

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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