OBJECTIVES: Previous reports suggested that the urine trypsinogen 2 (U-TRP2) test might be a valuable method for the diagnosis of postoperative pancreatitis after pancreatic surgery. We hypothesize that the elevation of U-TRP2 level after pancreaticoduodenectomy (PD) could be associated with the occurrence of postoperative pancreatic fistula (POPF). METHODS: A total of 130 consecutive patients undergoing PD with duct-to-mucosa pancreaticogastrostomy were included. Urine samples for evaluation of U-TRP2 levels were collected prospectively. Risk factors for POPF were evaluated using univariate and multivariate analyses. RESULTS: Of 130 patients, 19 developed POPF; grade A in 14 (11%), grade B in 3 (2%), and grade C in 1 (1%). Univariate analysis demonstrated that a nonobstructed main pancreatic duct, a pancreatic duct less than 3 mm, soft texture of the pancreatic gland, a PD with antrectomy, PD with hepatic resection, hyperamylasemia, and elevation of U-TRP2 levels (>50 μg/L) were significantly associated with POPF (P < 0.05). By multivariate analysis, elevation of U-TRP2 levels (odds ratio = 4.544, P = 0.029) was the only independent risk factor that correlated with POPF. CONCLUSIONS: Elevation of U-TRP2 level is an independent risk factor for POPF after PD. Elevated U-TRP2 level might be the consequence of the postoperative pancreatitis, and postoperative pancreatitis may play an important role in the pathogenic mechanism of POPF after PD.
OBJECTIVES: Previous reports suggested that the urine trypsinogen 2 (U-TRP2) test might be a valuable method for the diagnosis of postoperative pancreatitis after pancreatic surgery. We hypothesize that the elevation of U-TRP2 level after pancreaticoduodenectomy (PD) could be associated with the occurrence of postoperative pancreatic fistula (POPF). METHODS: A total of 130 consecutive patients undergoing PD with duct-to-mucosa pancreaticogastrostomy were included. Urine samples for evaluation of U-TRP2 levels were collected prospectively. Risk factors for POPF were evaluated using univariate and multivariate analyses. RESULTS: Of 130 patients, 19 developed POPF; grade A in 14 (11%), grade B in 3 (2%), and grade C in 1 (1%). Univariate analysis demonstrated that a nonobstructed main pancreatic duct, a pancreatic duct less than 3 mm, soft texture of the pancreatic gland, a PD with antrectomy, PD with hepatic resection, hyperamylasemia, and elevation of U-TRP2 levels (>50 μg/L) were significantly associated with POPF (P < 0.05). By multivariate analysis, elevation of U-TRP2 levels (odds ratio = 4.544, P = 0.029) was the only independent risk factor that correlated with POPF. CONCLUSIONS: Elevation of U-TRP2 level is an independent risk factor for POPF after PD. Elevated U-TRP2 level might be the consequence of the postoperative pancreatitis, and postoperative pancreatitis may play an important role in the pathogenic mechanism of POPF after PD.
Authors: Lavanniya K Palani Velu; Vishnu V Chandrabalan; Salman Jabbar; Donald C McMillan; Colin J McKay; C Ross Carter; Nigel B Jamieson; Euan J Dickson Journal: HPB (Oxford) Date: 2013-11-07 Impact factor: 3.647
Authors: Massimo Sartelli; Alain Chichom-Mefire; Francesco M Labricciosa; Timothy Hardcastle; Fikri M Abu-Zidan; Abdulrashid K Adesunkanmi; Luca Ansaloni; Miklosh Bala; Zsolt J Balogh; Marcelo A Beltrán; Offir Ben-Ishay; Walter L Biffl; Arianna Birindelli; Miguel A Cainzos; Gianbattista Catalini; Marco Ceresoli; Asri Che Jusoh; Osvaldo Chiara; Federico Coccolini; Raul Coimbra; Francesco Cortese; Zaza Demetrashvili; Salomone Di Saverio; Jose J Diaz; Valery N Egiev; Paula Ferrada; Gustavo P Fraga; Wagih M Ghnnam; Jae Gil Lee; Carlos A Gomes; Andreas Hecker; Torsten Herzog; Jae Il Kim; Kenji Inaba; Arda Isik; Aleksandar Karamarkovic; Jeffry Kashuk; Vladimir Khokha; Andrew W Kirkpatrick; Yoram Kluger; Kaoru Koike; Victor Y Kong; Ari Leppaniemi; Gustavo M Machain; Ronald V Maier; Sanjay Marwah; Michael E McFarlane; Giulia Montori; Ernest E Moore; Ionut Negoi; Iyiade Olaoye; Abdelkarim H Omari; Carlos A Ordonez; Bruno M Pereira; Gerson A Pereira Júnior; Guntars Pupelis; Tarcisio Reis; Boris Sakakhushev; Norio Sato; Helmut A Segovia Lohse; Vishal G Shelat; Kjetil Søreide; Waldemar Uhl; Jan Ulrych; Harry Van Goor; George C Velmahos; Kuo-Ching Yuan; Imtiaz Wani; Dieter G Weber; Sanoop K Zachariah; Fausto Catena Journal: World J Emerg Surg Date: 2017-07-10 Impact factor: 5.469