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

  • Riccardo Casadei Department of Surgery, “Alma Mater Studiorum” University of di Bologna, S.Orsola-Malpighi Hospital. Bologna, Italy
  • Claudio Ricci Department of Surgery, “Alma Mater Studiorum” University of di Bologna, S.Orsola-Malpighi Hospital. Bologna, Italy
  • Raffaele Pezzilli Department of Internal Medicine, “Alma Mater Studiorum” University of di Bologna, S.Orsola-Malpighi Hospital. Bologna, Italy
  • Lucia Calculli Department of Radiology, “Alma Mater Studiorum” University of di Bologna, S.Orsola-Malpighi Hospital. Bologna, Italy
  • Marielda D’Ambra Department of Surgery, “Alma Mater Studiorum” University of di Bologna, S.Orsola-Malpighi Hospital. Bologna, Italy
  • Giovanni Taffurelli Department of Surgery, “Alma Mater Studiorum” University of di Bologna, S.Orsola-Malpighi Hospital. Bologna, Italy
  • Francesco Minni Department of Surgery, “Alma Mater Studiorum” University of di Bologna, S.Orsola-Malpighi Hospital. Bologna, Italy
Keywords: Morbidity, Pancreas, Pancreatectomy

Abstract

Context The absence of a definition and a widely accepted ranking system to classify surgical complications has hampered proper interpretation of the surgical outcome. Patients Sixty-one patients undergoing distal pancreatectomy. Main outcome measures The complications were classified according to the Clavien-Dindo classification; each grade was evaluated regarding the length of the postoperative stay and was compared to the most important complications. Results Thirty (49.2%) patients had no complications; 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 grade IV. There were no postoperative deaths (grade V). A progressive increase in the length of hospitalization from patients with no complications to those having grade IV (P<0.001) was noted. Postoperative pancreatic fistula and postpancreatectomy hemorrhage rates did not significantly increase from Clavien-Dindo grade I to grade IV (P=0.118 and P=0.226, respectively). The severity of a postpancreatectomy hemorrhage, instead, was positively related to the grade of the Clavien-Dindo classification (P=0.049) while postoperative pancreatic fistula resulted near the significant value (P=0.058). Conclusions The Clavien-Dindo classification is a simple way of reporting all complications following distal pancreatectomy. It allows us to distinguish a normal postoperative course from any deviation and the severity of complications and it may be useful for comparing postoperative morbidity between different pancreatic centers.

Image: Relationship between the length of the postoperative stay and the Clavien-Dindo classification.

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References

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Relationship between the length of the postoperative stay and the Clavien-Dindo classification
Published
2011-03-09
How to Cite
CasadeiR., RicciC., PezzilliR., CalculliL., D’AmbraM., TaffurelliG., & MinniF. (2011). Assessment of Complications According to the Clavien-Dindo Classification After Distal Pancreatectomy. JOP. Journal of the Pancreas, 12(2), 126-130. https://doi.org/10.6092/1590-8577/3339
Section
ORIGINAL ARTICLE