Elisa Bannone, Alice Cattelani, Gaetano Corvino, Alessio Marchetti, Valentina Andreasi, Francesca Fermi, Stefano Partelli, Nicolò Pecorelli, Domenico Tamburrino, Alessandro Esposito, Giuseppe Malleo, Manish Bhandare, Kaival Gundavda, Kuirong Jiang, Zipeng Lu, Jie Yin, Harish Lavu, Rosa Klotz, Daniela Merz, Christoph Michalski, Ulla Klaiber, Marco Montorsi, Gennaro Nappo, Naoki Ikenaga, Pasquale Scornamiglio, Bodil Andersson, Fraser Jeffery, Daniel Halloran, Robert Padbury, Ajith K Siriwardena, Savio George Barreto, Luca Gianotti, Attila Oláh, Christopher M Halloran, Saxon Connor, Roland Andersson, Jakob R Izbicki, Masafumi Nakamura, Alessandro Zerbi, Mohammad Abu Hilal, Martin Loos, Charles J Yeo, Yi Miao, Massimo Falconi, Christos Dervenis, John P Neoptolemos, Markus W Büchler, Marc G Besselink, Cristina Ferrone, Thilo Hackert, Roberto Salvia, Shailesh V Shrikhande, Oliver Strobel, Jens Werner, Christopher L Wolfgang, Giovanni Marchegiani
{"title":"国际胰腺外科研究小组 (ISGPS) 胰腺切除术后急性胰腺炎 (PPAP) 定义的临床和财务验证:国际多中心前瞻性研究。","authors":"Elisa Bannone, Alice Cattelani, Gaetano Corvino, Alessio Marchetti, Valentina Andreasi, Francesca Fermi, Stefano Partelli, Nicolò Pecorelli, Domenico Tamburrino, Alessandro Esposito, Giuseppe Malleo, Manish Bhandare, Kaival Gundavda, Kuirong Jiang, Zipeng Lu, Jie Yin, Harish Lavu, Rosa Klotz, Daniela Merz, Christoph Michalski, Ulla Klaiber, Marco Montorsi, Gennaro Nappo, Naoki Ikenaga, Pasquale Scornamiglio, Bodil Andersson, Fraser Jeffery, Daniel Halloran, Robert Padbury, Ajith K Siriwardena, Savio George Barreto, Luca Gianotti, Attila Oláh, Christopher M Halloran, Saxon Connor, Roland Andersson, Jakob R Izbicki, Masafumi Nakamura, Alessandro Zerbi, Mohammad Abu Hilal, Martin Loos, Charles J Yeo, Yi Miao, Massimo Falconi, Christos Dervenis, John P Neoptolemos, Markus W Büchler, Marc G Besselink, Cristina Ferrone, Thilo Hackert, Roberto Salvia, Shailesh V Shrikhande, Oliver Strobel, Jens Werner, Christopher L Wolfgang, Giovanni Marchegiani","doi":"10.1097/SLA.0000000000006569","DOIUrl":null,"url":null,"abstract":"<p><strong>Objective: </strong>To validate the ISGPS definition and grading system of PPAP after pancreatoduodenectomy (PD).</p><p><strong>Summary background data: </strong>In 2022, the International Study Group for Pancreatic Surgery (ISGPS) defined post-pancreatectomy acute pancreatitis (PPAP) and recommended a prospective validation of its diagnostic criteria and grading system.</p><p><strong>Methods: </strong>This was a prospective, international, multicenter study including patients undergoing PD at 17 referral pancreatic centers across Europe, Asia, Oceania, and the United States. PPAP diagnosis required the following three parameters: (1) postoperative serum hyperamylasemia /hyperlipasemia (POH) persisting on postoperative days 1 and 2, (2) radiologic alterations consistent with PPAP, and (3) a clinically relevant deterioration in the patient's condition. To validate the grading system, clinical and economic parameters were analyzed across all grades.</p><p><strong>Results: </strong>Among 2902 patients undergoing PD, 7.5% (n=218) developed PPAP (6.3% grade B and 1.2% grade C). POH occurred in 24.1% of patients. Hospital stay was associated with PPAP grades (No POH/PPAP 10 days (IQR 7-17) days, grade B 22 days (IQR 15-34) days, and grade C 43 days (IQR 27-54) days; P<0.001), as well as intensive care unit admission (No POH/PPAP 5.4%, grade B 12.6%, grade C 82.9%; P<0.010), and hospital readmission rates (No POH/PPAP 7.3%, grade B 16.1%, grade C 18.5%; P<0.05). Costs of grade B and C PPAP were 2 and 11 times greater than uncomplicated clinical course, resp. (P<0.001).</p><p><strong>Conclusions: </strong>This first prospective, international validation study of the ISGPS definition and grading system for PPAP highlighted the relevant clinical and financial implications of this condition. These results stress the importance of routine screening for PPAP in patients undergoing PD.</p>","PeriodicalId":8017,"journal":{"name":"Annals of surgery","volume":" ","pages":""},"PeriodicalIF":7.5000,"publicationDate":"2024-10-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Clinical and Financial Validation of the International Study Group for Pancreatic Surgery (ISGPS) Definition of Post-Pancreatectomy Acute Pancreatitis (PPAP): International Multicenter Prospective Study.\",\"authors\":\"Elisa Bannone, Alice Cattelani, Gaetano Corvino, Alessio Marchetti, Valentina Andreasi, Francesca Fermi, Stefano Partelli, Nicolò Pecorelli, Domenico Tamburrino, Alessandro Esposito, Giuseppe Malleo, Manish Bhandare, Kaival Gundavda, Kuirong Jiang, Zipeng Lu, Jie Yin, Harish Lavu, Rosa Klotz, Daniela Merz, Christoph Michalski, Ulla Klaiber, Marco Montorsi, Gennaro Nappo, Naoki Ikenaga, Pasquale Scornamiglio, Bodil Andersson, Fraser Jeffery, Daniel Halloran, Robert Padbury, Ajith K Siriwardena, Savio George Barreto, Luca Gianotti, Attila Oláh, Christopher M Halloran, Saxon Connor, Roland Andersson, Jakob R Izbicki, Masafumi Nakamura, Alessandro Zerbi, Mohammad Abu Hilal, Martin Loos, Charles J Yeo, Yi Miao, Massimo Falconi, Christos Dervenis, John P Neoptolemos, Markus W Büchler, Marc G Besselink, Cristina Ferrone, Thilo Hackert, Roberto Salvia, Shailesh V Shrikhande, Oliver Strobel, Jens Werner, Christopher L Wolfgang, Giovanni Marchegiani\",\"doi\":\"10.1097/SLA.0000000000006569\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Objective: </strong>To validate the ISGPS definition and grading system of PPAP after pancreatoduodenectomy (PD).</p><p><strong>Summary background data: </strong>In 2022, the International Study Group for Pancreatic Surgery (ISGPS) defined post-pancreatectomy acute pancreatitis (PPAP) and recommended a prospective validation of its diagnostic criteria and grading system.</p><p><strong>Methods: </strong>This was a prospective, international, multicenter study including patients undergoing PD at 17 referral pancreatic centers across Europe, Asia, Oceania, and the United States. PPAP diagnosis required the following three parameters: (1) postoperative serum hyperamylasemia /hyperlipasemia (POH) persisting on postoperative days 1 and 2, (2) radiologic alterations consistent with PPAP, and (3) a clinically relevant deterioration in the patient's condition. To validate the grading system, clinical and economic parameters were analyzed across all grades.</p><p><strong>Results: </strong>Among 2902 patients undergoing PD, 7.5% (n=218) developed PPAP (6.3% grade B and 1.2% grade C). POH occurred in 24.1% of patients. Hospital stay was associated with PPAP grades (No POH/PPAP 10 days (IQR 7-17) days, grade B 22 days (IQR 15-34) days, and grade C 43 days (IQR 27-54) days; P<0.001), as well as intensive care unit admission (No POH/PPAP 5.4%, grade B 12.6%, grade C 82.9%; P<0.010), and hospital readmission rates (No POH/PPAP 7.3%, grade B 16.1%, grade C 18.5%; P<0.05). Costs of grade B and C PPAP were 2 and 11 times greater than uncomplicated clinical course, resp. (P<0.001).</p><p><strong>Conclusions: </strong>This first prospective, international validation study of the ISGPS definition and grading system for PPAP highlighted the relevant clinical and financial implications of this condition. These results stress the importance of routine screening for PPAP in patients undergoing PD.</p>\",\"PeriodicalId\":8017,\"journal\":{\"name\":\"Annals of surgery\",\"volume\":\" \",\"pages\":\"\"},\"PeriodicalIF\":7.5000,\"publicationDate\":\"2024-10-22\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Annals of surgery\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.1097/SLA.0000000000006569\",\"RegionNum\":1,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q1\",\"JCRName\":\"SURGERY\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Annals of surgery","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1097/SLA.0000000000006569","RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"SURGERY","Score":null,"Total":0}
Clinical and Financial Validation of the International Study Group for Pancreatic Surgery (ISGPS) Definition of Post-Pancreatectomy Acute Pancreatitis (PPAP): International Multicenter Prospective Study.
Objective: To validate the ISGPS definition and grading system of PPAP after pancreatoduodenectomy (PD).
Summary background data: In 2022, the International Study Group for Pancreatic Surgery (ISGPS) defined post-pancreatectomy acute pancreatitis (PPAP) and recommended a prospective validation of its diagnostic criteria and grading system.
Methods: This was a prospective, international, multicenter study including patients undergoing PD at 17 referral pancreatic centers across Europe, Asia, Oceania, and the United States. PPAP diagnosis required the following three parameters: (1) postoperative serum hyperamylasemia /hyperlipasemia (POH) persisting on postoperative days 1 and 2, (2) radiologic alterations consistent with PPAP, and (3) a clinically relevant deterioration in the patient's condition. To validate the grading system, clinical and economic parameters were analyzed across all grades.
Results: Among 2902 patients undergoing PD, 7.5% (n=218) developed PPAP (6.3% grade B and 1.2% grade C). POH occurred in 24.1% of patients. Hospital stay was associated with PPAP grades (No POH/PPAP 10 days (IQR 7-17) days, grade B 22 days (IQR 15-34) days, and grade C 43 days (IQR 27-54) days; P<0.001), as well as intensive care unit admission (No POH/PPAP 5.4%, grade B 12.6%, grade C 82.9%; P<0.010), and hospital readmission rates (No POH/PPAP 7.3%, grade B 16.1%, grade C 18.5%; P<0.05). Costs of grade B and C PPAP were 2 and 11 times greater than uncomplicated clinical course, resp. (P<0.001).
Conclusions: This first prospective, international validation study of the ISGPS definition and grading system for PPAP highlighted the relevant clinical and financial implications of this condition. These results stress the importance of routine screening for PPAP in patients undergoing PD.
期刊介绍:
The Annals of Surgery is a renowned surgery journal, recognized globally for its extensive scholarly references. It serves as a valuable resource for the international medical community by disseminating knowledge regarding important developments in surgical science and practice. Surgeons regularly turn to the Annals of Surgery to stay updated on innovative practices and techniques. The journal also offers special editorial features such as "Advances in Surgical Technique," offering timely coverage of ongoing clinical issues. Additionally, the journal publishes monthly review articles that address the latest concerns in surgical practice.