title: The usefulness of a grading system for complications resulting from pancreatic resections: a single center experience.
abstract: The aim of this study was to test the usefulness of the Clavien-Dindo classification after pancreatic resection. In 183 patients who underwent pancreatic resections, complications were classified according to Clavien-Dindo classification and each grade was evaluated regarding the length of the postoperative stay and was compared to the most important complications. Sixty-four (35.0%) patients had no complications; out of the 119 (65.0%) patients with complications, grade I, was 9.3%; grade II, 35.5%; grade III, 9.3%; grade IV, 7.7% and grade V, 3.3%. The postoperative pancreatic fistula rate was 29.1%, postpancreatectomy hemorrhage, 35% and delayed gastric emptying, 11.5%. There was a progressive increase in the length of hospitalization from patients with no complications to those having grade IV (P < 0.001). Postoperative pancreatic fistula, postpancreatectomy hemorrhage and delayed gastric empty rates significantly increased from Clavien-Dindo grade I to grade IV; only postoperative pancreatic fistula and postpancreatectomy hemorrhage severity significantly increased from grade I to grade IV (both P < 0.001). The Clavien-Dindo classification is an objective, simple, and reliable way of reporting all complications following pancreatic resections and it allows to recognize appropriately all the most important complications after pancreatic resection, and the severity of postoperative pancreatic fistula and postpancreatectomy hemorrhage.
authors.affiliation: Dipartimento di Scienze Chirurgiche e Anestesiologiche, Chirurgia Generale-Minni, Alma Mater Studiorum, Università di Bologna, Policlinico S.Orsola-Malpighi, Via Massarenti n.9, 40138 Bologna, Italy. riccardo.casadei@aosp.bo.it
authors.forename: Riccardo
authors.initials: R
authors.lastname: Casadei
authors.forename: Claudio
authors.initials: C
authors.lastname: Ricci
authors.forename: Raffaele
authors.initials: R
authors.lastname: Pezzilli
authors.forename: Antonio Maria
authors.initials: AM
authors.lastname: Morselli-Labate
authors.forename: Lucia
authors.initials: L
authors.lastname: Calculli
authors.forename: Marielda
authors.initials: M
authors.lastname: D'Ambra
authors.forename: Francesco
authors.initials: F
authors.lastname: Monari
authors.forename: Giovanni
authors.initials: G
authors.lastname: Taffurelli
authors.forename: Francesco
authors.initials: F
authors.lastname: Minni
mesh_terms: D000704:Analysis of Variance; D016009:Chi-Square Distribution; D015897:Comorbidity; D005260:Female; D006801:Humans; D007902:Length of Stay / Q000706:statistics & numerical data; D008297:Male; D008875:Middle Aged; D010190:Pancreatic Neoplasms / Q000401:mortality / Q000601:surgery*; D011183:Postoperative Complications / Q000145:classification* / Q000401:mortality; D011446:Prospective Studies; D012307:Risk Factors; D018709:Statistics, Nonparametric