title: Clinically relevant pancreas-related infectious complication after pancreaticoenteral anastomosis could be predicted by the parameters obtained on postoperative day 3.
abstract: OBJECTIVE
  Pancreatic fistula or pancreas-related infectious complications are one of the most common surgical complications after pancreatic surgery. The aims of this study were, first, to reveal the risk factors for clinically relevant pancreas-related infectious complications and, second, to identify those risk factors that are obtainable within the first 3 postoperative days.
  
  
  METHODS
  One hundred seven consecutive patients who underwent pancreaticoenteral anastomosis between October 2007 and November 2010 were enrolled.
  
  
  RESULTS
  There were 36 patients with clinical pancreas-related infectious complications among 107 in this series of patients. Univariate and multivariate analyses revealed that a narrow main pancreatic duct diameter (<3 mm) was an independent risk factor for clinically relevant pancreas-related infectious complication. Univariate and multivariate analyses also revealed that a body temperature of 38°C or higher on postoperative day 3 (POD3), a leukocyte count of 9.8 × 10(9)/L or greater on POD3, and a drain fluid amylase level of 3000 IU/L or higher on POD3 were significant predictive factors for clinically relevant pancreas-related infectious complication for 58 patients with a narrow main pancreatic duct.
  
  
  CONCLUSIONS
  In view of the clinical variables obtained on POD3, such as amylase levels in drain effluent, body temperature, and leukocyte count, clinically relevant pancreas-related infections could be predicted well.
authors.affiliation: Department of Surgery, Teine-Keijinkai Hospital, Sapporo, Hokkaido, Japan. drnoji@yahoo.co.jp
authors.forename: Takehiro
authors.initials: T
authors.lastname: Noji
authors.forename: Toru
authors.initials: T
authors.lastname: Nakamura
authors.forename: Yoshiyasu
authors.initials: Y
authors.lastname: Ambo
authors.forename: On
authors.initials: O
authors.lastname: Suzuki
authors.forename: Fumitaka
authors.initials: F
authors.lastname: Nakamura
authors.forename: Akihiro
authors.initials: A
authors.lastname: Kishida
authors.forename: Satoshi
authors.initials: S
authors.lastname: Hirano
authors.forename: Satoshi
authors.initials: S
authors.lastname: Kondo
authors.forename: Nobuichi
authors.initials: N
authors.lastname: Kashimura
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000681:Amylases / Q000378:metabolism; D015415:Biomarkers / Q000378:metabolism; D001831:Body Temperature; D016009:Chi-Square Distribution; D005260:Female; D006801:Humans; D007564:Japan; D007958:Leukocyte Count; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D016017:Odds Ratio; D010185:Pancreatic Fistula / Q000097:blood / Q000175:diagnosis / Q000209:etiology* / Q000503:physiopathology; D016577:Pancreaticoduodenectomy / Q000009:adverse effects*; D010193:Pancreaticojejunostomy / Q000009:adverse effects*; D011237:Predictive Value of Tests; D018570:Risk Assessment; D012307:Risk Factors; D013530:Surgical Wound Infection / Q000097:blood / Q000175:diagnosis / Q000209:etiology* / Q000503:physiopathology; D013997:Time Factors; D016896:Treatment Outcome
chemical_list: D015415:Biomarkers; D000681:Amylases