Assessment of two different criteria for post-pancreatectomy acute pancreatitis: a single-center retrospective analysis and literature review.

BACKGROUND

The significance of postoperative acute pancreatitis (postoperative pancreatitis [POP] as defined by Connor and post-pancreatectomy acute pancreatitis [PPAP] as defined by the International Study Group for Pancreatic Surgery [ISGPS]) has not been determined because of the transition of definitions, a lack of prospective studies and ignorance regarding appropriate management.

METHODS

The incidence of POP/PPAP were retrospectively analyzed. Additionally, the clinicopathological parameters and outcomes were compared between patients with and without POP/PPAP.

RESULTS

Using Connor's criteria, 46% of patients (70/151) showed Grade A POP and 17% (26/151) displayed clinically relevant (CR)-POP. Using ISGPS criteria, the prevalences of postoperative hyperamylasemia and CR-PPAP were 12% (18/151) and 10% (15/151), respectively. The duration of antibiotics and carbapenem were longer in CR-POP (p < 0.001). Total health care cost was significantly higher in CR-POP compared with other grades in Connor's criteria (p = 0.010), whereas no difference was seen in the ISGPS criteria (p = 0.677). The frequencies of complications including pancreatic fistula (Non-POP vs. Grade A POP vs. CR-POP, 22% vs. 36% vs. 81%, p < 0.001), reoperation and length of hospital stay tended to be greater as Connor's grade of POP increased.

DISCUSSION: Connor's definition appeared more closely associated with postoperative worse outcomes than the ISGPS definition.