Assessment of a complication risk score and study of complication profile in laparoscopic distal pancreatectomy

J Gastrointest Surg. 2014 Nov;18(11):2009-15. doi: 10.1007/s11605-014-2651-9. Epub 2014 Sep 20.


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.

Conclusion: 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.

Publication types

  • Evaluation Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Aged
  • Analysis of Variance
  • Cohort Studies
  • Confidence Intervals
  • Databases, Factual
  • Disease-Free Survival
  • Female
  • Follow-Up Studies
  • Humans
  • Italy
  • Laparoscopy / adverse effects*
  • Laparoscopy / methods
  • Male
  • Middle Aged
  • Odds Ratio
  • Pancreatectomy / adverse effects*
  • Pancreatectomy / methods
  • Pancreatic Fistula / diagnosis
  • Pancreatic Fistula / mortality*
  • Pancreatic Fistula / surgery
  • Pancreatic Neoplasms / mortality*
  • Pancreatic Neoplasms / pathology
  • Pancreatic Neoplasms / surgery*
  • Postoperative Complications / diagnosis*
  • Postoperative Complications / mortality
  • Postoperative Complications / therapy
  • Retrospective Studies
  • Risk Assessment
  • Survival Analysis
  • Treatment Outcome