Assessment of Complications According to the Clavien-Dindo Classification After Distal Pancreatectomy

摘要

Context The absence of a definition and awidely accepted ranking system to classify surgical complications has hamperedproper interpretation of the surgical outcome. Patients Sixty-onepatients undergoing distal pancreatectomy. Main outcome measures The complicationswere classified according to the Clavien-Dindo classification; each grade was evaluatedregarding the length of the postoperative stay and was compared to the mostimportant complications. Results Thirty (49.2%) patients had nocomplications; out of the thirty-one (50.8%) patients with complications, 9 (14.5%)had grade I, 15 (24.6%) had grade II, 6 (9.8%) had grade III, and 1 (1.6%) had gradeIV. There were no postoperative deaths (grade V). A progressive increase in thelength of hospitalization from patients with no complications to those havinggrade IV (P<0.001) was noted. Postoperative pancreatic fistula and postpancreatectomyhemorrhage rates did not significantly increase from Clavien-Dindo grade I to gradeIV (P=0.118 and P=0.226, respectively). The severity of a postpancreatectomyhemorrhage, instead, was positively related to the grade of the Clavien-Dindoclassification (P=0.049) while postoperative pancreatic fistula resulted nearthe significant value (P=0.058). Conclusions The Clavien-Dindoclassification is a simple way of reporting all complications following distalpancreatectomy. It allows us to distinguish a normal postoperative course fromany deviation and the severity of complications and it may be useful forcomparing postoperative morbidity between different pancreatic centers.