title: Assessment of a complication risk score and study of complication profile in laparoscopic distal pancreatectomy.
abstract: OBJECTIVE
  This study assessed the patient-specific risk for major postoperative morbidity in a series of 100 laparoscopic distal pancreatectomies (LDP).
  
  
  METHODS
  A previously established complication risk score (CRS), identifying body mass index (BMI), estimated blood loss (EBL), and pancreatic specimen length as determinants of postoperative morbidity were examined against the observed outcomes. In addition, multivariate analyses were performed to investigate risk factors specific to our study population.
  
  
  RESULTS
  The postoperative morbidity rate was 49 %, major complication accounted for 12 %, and clinically relevant pancreatic fistulae (PF) were 13 %. The incidence of any complications, major complications, any PF, and clinically relevant PF did not vary appreciably when the CRS increased. The multivariate analysis indicated that male sex and an EBL ≥150 mL were independent predictors of major morbidity and clinically relevant PF.
  
  
  CONCLUSIONS
  In conclusion, the previously published CRS based on pre- and intraoperative factors was not able to predict the postoperative risk in our population. This is probably because risk scores may not be able to adjust for the case-mix (heterogeneity in baseline patient characteristics). According to our data, men and patients with EBL ≥150 mL are more likely to develop major postoperative complications after LDP.
authors.affiliation: Unit of Surgery B, The Pancreas Institute, Department of Surgery and Oncology, G.B. Rossi Hospital, University of Verona Hospital Trust, P.Le L.A. Scuro 10, 37134, Verona, Italy.
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Malleo
authors.forename: Roberto
authors.initials: R
authors.lastname: Salvia
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Mascetta
authors.forename: Alessandro
authors.initials: A
authors.lastname: Esposito
authors.forename: Luca
authors.initials: L
authors.lastname: Landoni
authors.forename: Luca
authors.initials: L
authors.lastname: Casetti
authors.forename: Laura
authors.initials: L
authors.lastname: Maggino
authors.forename: Claudio
authors.initials: C
authors.lastname: Bassi
authors.forename: Giovanni
authors.initials: G
authors.lastname: Butturini
mesh_terms: D000328:Adult; D000368:Aged; D000704:Analysis of Variance; D015331:Cohort Studies; D016001:Confidence Intervals; D016208:Databases, Factual; D018572:Disease-Free Survival; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007558:Italy; D010535:Laparoscopy / Q000009:adverse effects* / Q000379:methods; D008297:Male; D008875:Middle Aged; D016017:Odds Ratio; D010180:Pancreatectomy / Q000009:adverse effects* / Q000379:methods; D010185:Pancreatic Fistula / Q000175:diagnosis / Q000401:mortality* / Q000601:surgery; D010190:Pancreatic Neoplasms / Q000401:mortality* / Q000473:pathology / Q000601:surgery*; D011183:Postoperative Complications / Q000175:diagnosis* / Q000401:mortality / Q000628:therapy; D012189:Retrospective Studies; D018570:Risk Assessment; D016019:Survival Analysis; D016896:Treatment Outcome