title: [Best time to administer coagulation factor XIII( Fibrogammin P) for postoperative intractable pancreatic fistula following gastrectomy for gastric cancer].
abstract: BACKGROUND
  Coagulation factor XIII( Fibrogammin P, F XIII) has been used to treat postoperative pancreatic fistulas following gastrectomy for gastric cancer in Japan. However, little is known about the best timing to start this treatment for early recovery. This study was designed to examine the appropriate time to start Fibrogammin P treatment for pancreatic fistulas, based on nutritional and inflammatory parameters.
  
  
  METHODS
  We retrospectively examined 27 consecutive patients with Grade B or C pancreatic fistulas as defined by the International Study Group of Pancreatic Fistula( ISGPF) classification who underwent gastrectomy at our institute between 1997 and 2011. We analyzed data on total protein( TP), albumin (Alb), C-reactive protein( CRP), and hemoglobin( Hb) concentrations and white blood cell( WBC) and lymphocyte counts. We used this information to determine laboratory cut-off values that indicate the most advantageous time to start the administration of Fibrogammin P in order to achieve early recovery within 2 weeks.
  
  
  RESULTS
  When Fibrogammin P administration was based on more than 2 cut-off values such as Alb>2.6 g/dL and Hb>9.0 g/dL and WBC<9,000/μL (p= 0.1563), early cure of pancreatic fistulas was achieved.
  
  
  CONCLUSIONS
  The use of nutritional and inflammatory parameter values to determine the best time to administer Fibrogammin P may shorten the treatment period.
authors.affiliation: Division of Digestive Surgery, Dept. of Surgery, Kyoto Prefectural University of Medicine.
authors.forename: Katsutoshi
authors.initials: K
authors.lastname: Shoda
authors.forename: Shuhei
authors.initials: S
authors.lastname: Komatsu
authors.forename: Daisuke
authors.initials: D
authors.lastname: Ichikawa
authors.forename: Takeshi
authors.initials: T
authors.lastname: Kubota
authors.forename: Kazuma
authors.initials: K
authors.lastname: Okamoto
authors.forename: Tomohiro
authors.initials: T
authors.lastname: Arita
authors.forename: Hirotaka
authors.initials: H
authors.lastname: Konishi
authors.forename: Yasutoshi
authors.initials: Y
authors.lastname: Murayama
authors.forename: Atsushi
authors.initials: A
authors.lastname: Shiozaki
authors.forename: Yoshiaki
authors.initials: Y
authors.lastname: Kuriu
authors.forename: Hisashi
authors.initials: H
authors.lastname: Ikoma
authors.forename: Masayoshi
authors.initials: M
authors.lastname: Nakanishi
authors.forename: Hitoshi
authors.initials: H
authors.lastname: Fujiwara
authors.forename: Eigo
authors.initials: E
authors.lastname: Otsuji
mesh_terms: D000368:Aged; D018479:Early Intervention, Educational; D005176:Factor XIII / Q000627:therapeutic use*; D005260:Female; D005743:Gastrectomy / Q000009:adverse effects*; D006801:Humans; D008297:Male; D010185:Pancreatic Fistula / Q000188:drug therapy* / Q000209:etiology; D011183:Postoperative Complications / Q000188:drug therapy*; D011184:Postoperative Period; D013274:Stomach Neoplasms / Q000601:surgery*
chemical_list: D005176:Factor XIII