NDLI: Impact of preoperative asymptomatic renal dysfunction on clinical course after pancreatoduodenectomy.

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Impact of preoperative asymptomatic renal dysfunction on clinical course after pancreatoduodenectomy.

Content Provider	World Health Organization (WHO)-Global Index Medicus
Author	Nagai, Minako Sho, Masayuki Akahori, Takahiro Tanaka, Toshihiro Kinoshita, Shoichi Nishiofuku, Hideyuki Nishiwada, Satoshi Ohbayashi, Chiho Kichikawa, Kimihiko Nakajima, Yoshiyuki
Description	Country affiliation: Japan Author Affiliation: Nagai M ( Department of Surgery, Nara Medical University, 840 Shijo-cho, Kashihara, Japan.); Sho M ( Department of Surgery, Nara Medical University, 840 Shijo-cho, Kashihara, Japan. m-sho@naramed-u.ac.jp.); Akahori T ( Department of Surgery, Nara Medical University, 840 Shijo-cho, Kashihara, Japan.); Tanaka T ( Department of Radiology, Nara Medical University, Kashihara, Nara 634-8522, Japan.); Kinoshita S ( Department of Surgery, Nara Medical University, 840 Shijo-cho, Kashihara, Japan.); Nishiofuku H ( Department of Radiology, Nara Medical University, Kashihara, Nara 634-8522, Japan.); Nishiwada S ( Department of Surgery, Nara Medical University, 840 Shijo-cho, Kashihara, Japan.); Ohbayashi C ( Department of Diagnostic Pathology, Nara Medical University, Kashihara, Japan.); Kichikawa K ( Department of Radiology, Nara Medical University, Kashihara, Nara 634-8522, Japan.); Nakajima Y ( Department of Surgery, Nara Medical University, 840 Shijo-cho, Kashihara, Japan.)
Abstract	BACKGROUND: Although recent large-scale clinical studies have shown that preoperative renal insufficiency is associated with increased risk of postoperative complications after pancreatoduodenectomy (PD), it is unknown whether asymptomatic renal dysfunction has an impact on postoperative course after PD. METHODS: Two hundred and fifty-four patients who underwent PD between 2007 and 2013 were enrolled. Renal function was evaluated by the preoperative estimated glomerular filtration rate (eGFR). Patients were divided into two groups according to the cutoff value of 55 of eGFR. RESULTS: Thirty-five patients were classified as the low eGFR group, while 219 were classified as the normal group. There were differences between groups in age, comorbidity and pancreatic texture. The incidence of overall postoperative complication, grade B/C pancreatic fistula and severe complication in the low eGFR group was significantly higher than that in the normal group. Multivariate analysis identified low eGFR as an independent risk factor for severe postoperative complications and grade B/C pancreatic fistula after PD. However, there were no differences in mortality and survival between the low and normal eGFR groups. CONCLUSIONS: We have demonstrated for the first time that preoperative asymptomatic renal dysfunction may be a significant risk factor for severe morbidity and clinically relevant pancreatic fistula after PD.
File Format	HTM / HTML
ISSN	18686974
Issue Number	11
Volume Number	22
Journal	Journal of Hepato-Biliary-Pancreatic Sciences
e-ISSN	18686982
Language	English
Publisher	Wiley
Publisher Date	2015-11-01
Publisher Place	Japan
Access Restriction	One Nation One Subscription (ONOS)
Subject Keyword	Discipline Gastroenterology Glomerular Filtration Rate Physiology Pancreaticoduodenectomy Adverse Effects Postoperative Complications Prevention & Control Renal Insufficiency Diagnosis Adult Aged Aged, 80 And Over Analysis Of Variance Cohort Studies Female Humans Kaplan-meier Estimate Kidney Function Tests Length Of Stay Logistic Models Male Middle Aged Multivariate Analysis Pancreatic Neoplasms Mortality Pathology Surgery Methods Epidemiology Predictive Value Of Tests Preoperative Care Complications Retrospective Studies Risk Assessment Severity Of Illness Index Survival Rate Treatment Outcome Comparative Study Journal Article Research Support, Non-u.s. Gov't
Content Type	Text
Resource Type	Article
Subject	Hepatology Surgery

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