title: Neuroendocrine pancreatic tumors are risk factors for pancreatic fistula after pancreatic surgery.
abstract: BACKGROUND
  Postoperative pancreatic fistula (PF) is still regarded as a major complication in pancreatic surgery. In the present study, we evaluated the risk of PF in a large study population of patients with neuroendocrine pancreatic tumors (NPT), pancreatic cancer (PC), and chronic pancreatitis (CP).
  
  
  METHODS
  Patients who underwent pancreatic surgery between 1989 and 2008 at our institution were retrospectively evaluated. Patients were analyzed regarding age, gender, BMI, alcohol, smoking, preoperative diabetes, reason for operation, operative procedure, and PF. Three different grades of PF (grades A, B, C) were defined.
  
  
  RESULTS
  133 patients with NPT, 212 patients with PC, 52 patients with CP, and 76 patients with other reasons were evaluated. Patients with a NPT had a significant higher risk of developing a PF than patients with PC, CP, or other reasons (p = 0.0001). Enucleation of the tumor was associated with the highest rate of PF (p = 0.001). In a multivariate analysis, BMI >26, and preoperative diabetes were associated with a higher rate of PF (p = 0.042 and p = 0.02, respectively).
  
  
  CONCLUSIONS
  We demonstrated that after excluding factors like different definitions of PF, or different peri- or postoperative management, patients with NPT have a significantly higher risk of postoperative PF than patients with other pancreatic diseases.
authors: Department of Surgery, Philipps-University Marburg, Marburg, Germany. fendrich@med.uni-marburg.de
authors: Volker
authors: V
authors: Fendrich
authors: Marianne K
authors: MK
authors: Merz
authors: Jens
authors: J
authors: Waldmann
authors: Peter
authors: P
authors: Langer
authors: Anna E
authors: AE
authors: Heverhagen
authors: Kristin
authors: K
authors: Dietzel
authors: Detlef K
authors: DK
authors: Bartsch
mesh_terms: D018784:Abdominal Abscess / Q000209:etiology; D000230:Adenocarcinoma / Q000150:complications / Q000601:surgery*; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D015992:Body Mass Index; D003920:Diabetes Mellitus / Q000453:epidemiology; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D018358:Neuroendocrine Tumors / Q000150:complications / Q000601:surgery*; D010185:Pancreatic Fistula / Q000453:epidemiology* / Q000209:etiology / Q000473:pathology; D010190:Pancreatic Neoplasms / Q000150:complications / Q000601:surgery*; D050500:Pancreatitis, Chronic / Q000150:complications / Q000601:surgery*; D011183:Postoperative Complications / Q000453:epidemiology* / Q000209:etiology; D012189:Retrospective Studies; D012307:Risk Factors; D018709:Statistics, Nonparametric; D055815:Young Adult