title: Clinical impact of preoperative acute pancreatitis in patients who undergo pancreaticoduodenectomy for periampullary tumors.
abstract: OBJECTIVE
  To investigate the impact of preoperative acute pancreatitis (PAP) on the surgical management of periampullary tumors.
  
  
  METHODS
  Fifty-eight patients with periampullary tumors and PAP were retrospectively analyzed. Thirty-four patients who underwent pancreaticoduodenectomy (PD) and 4 patients who underwent total pancreatectomy were compared with a control group of 145 patients without PAP during the same period.
  
  
  RESULTS
  The preoperative waiting time was significantly shorter for the concomitant PAP patients who underwent a resection (22.4 d vs 54.6 d, P < 0.001) compared to those who did not. The presence of PAP significantly increased the rate of severe complications (Clavien grade 3 or higher) (17.6% vs 4.8%, P = 0.019) and lengthened the hospital stay (19.5 d vs 14.5 d, P = 0.006). A multivariate logistic regression analysis revealed that PAP was an independent risk factor for postoperative pancreatic fistula (OR = 2.91; 95%CI: 1.10-7.68; P = 0.032) and severe complications (OR = 4.70; 95%CI: 1.48-14.96; P = 0.009) after PD. There was no perioperative mortality.
  
  
  CONCLUSIONS
  PAP significantly increases the incidence of severe complications and lengthens the hospital stay following PD. PD could be safely performed in highly selective patients with PAP.
authors.affiliation: Yong-Hua Chen, Si-Ming Xie, Hao Zhang, Chun-Lu Tan, Neng-Wen Ke, Gang Mai, Xu-Bao Liu, Department of Hepatobiliopancreatic Surgery, West China Hospital, Sichuan University, Chengdu 610041, Sichuan Province, China.
authors.forename: Yong-Hua
authors.initials: YH
authors.lastname: Chen
authors.affiliation: Yong-Hua Chen, Si-Ming Xie, Hao Zhang, Chun-Lu Tan, Neng-Wen Ke, Gang Mai, Xu-Bao Liu, Department of Hepatobiliopancreatic Surgery, West China Hospital, Sichuan University, Chengdu 610041, Sichuan Province, China.
authors.forename: Si-Ming
authors.initials: SM
authors.lastname: Xie
authors.affiliation: Yong-Hua Chen, Si-Ming Xie, Hao Zhang, Chun-Lu Tan, Neng-Wen Ke, Gang Mai, Xu-Bao Liu, Department of Hepatobiliopancreatic Surgery, West China Hospital, Sichuan University, Chengdu 610041, Sichuan Province, China.
authors.forename: Hao
authors.initials: H
authors.lastname: Zhang
authors.affiliation: Yong-Hua Chen, Si-Ming Xie, Hao Zhang, Chun-Lu Tan, Neng-Wen Ke, Gang Mai, Xu-Bao Liu, Department of Hepatobiliopancreatic Surgery, West China Hospital, Sichuan University, Chengdu 610041, Sichuan Province, China.
authors.forename: Chun-Lu
authors.initials: CL
authors.lastname: Tan
authors.affiliation: Yong-Hua Chen, Si-Ming Xie, Hao Zhang, Chun-Lu Tan, Neng-Wen Ke, Gang Mai, Xu-Bao Liu, Department of Hepatobiliopancreatic Surgery, West China Hospital, Sichuan University, Chengdu 610041, Sichuan Province, China.
authors.forename: Neng-Wen
authors.initials: NW
authors.lastname: Ke
authors.affiliation: Yong-Hua Chen, Si-Ming Xie, Hao Zhang, Chun-Lu Tan, Neng-Wen Ke, Gang Mai, Xu-Bao Liu, Department of Hepatobiliopancreatic Surgery, West China Hospital, Sichuan University, Chengdu 610041, Sichuan Province, China.
authors.forename: Gang
authors.initials: G
authors.lastname: Mai
authors.affiliation: Yong-Hua Chen, Si-Ming Xie, Hao Zhang, Chun-Lu Tan, Neng-Wen Ke, Gang Mai, Xu-Bao Liu, Department of Hepatobiliopancreatic Surgery, West China Hospital, Sichuan University, Chengdu 610041, Sichuan Province, China.
authors.forename: Xu-Bao
authors.initials: XB
authors.lastname: Liu
mesh_terms: D000208:Acute Disease; D000328:Adult; D000368:Aged; D016009:Chi-Square Distribution; D003138:Common Bile Duct Neoplasms / Q000150:complications / Q000473:pathology / Q000601:surgery*; D005260:Female; D006801:Humans; D007902:Length of Stay; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D016017:Odds Ratio; D010180:Pancreatectomy / Q000009:adverse effects; D010185:Pancreatic Fistula / Q000175:diagnosis / Q000209:etiology; D016577:Pancreaticoduodenectomy / Q000009:adverse effects; D010195:Pancreatitis / Q000175:diagnosis / Q000209:etiology*; D012189:Retrospective Studies; D012307:Risk Factors; D013997:Time Factors; D061665:Time-to-Treatment; D016896:Treatment Outcome; D014850:Waiting Lists
keywords: Complications; Pancreatic fistula; Pancreaticoduodenectomy; Preoperative pancreatitis