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Please use this identifier to cite or link to this item: http://hdl.handle.net/10564/3327

Title: Impact of preoperative asymptomatic renal dysfunction on clinical course after pancreatoduodenectomy.
Other Titles: 無症候性腎機能障害が膵頭十二指腸切除術後臨床経過に及ぼす影響
Authors: Nagai, Minako
Sho, Masayuki
Akahori, Takahiro
Tanaka, Toshihiro
Kinoshita, Shoichi
Nishiofuku, Hideyuki
Nishiwada, Satoshi
Ohbayashi, Chiho
Kichikawa, Kimihiko
Nakajima, Yoshiyuki
Keywords: Pancreatoduodenectomy
Postoperative complication
Prognosis
Renal dysfunction
Surgery
Issue Date: Nov-2015
Publisher: John Wiley & Sons, Inc.
Citation: Journal of hepato-biliary-pancreatic sciences Vol.22 No.11 p.810-818 (2015 Nov)
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.
Description: 博士(医学)・乙第1394号・平成29年3月15日
© 2015 Japanese Society of Hepato-Biliary-Pancreatic Surgery.
This is the peer reviewed version of the following article: http://dx.doi.org/10.1002/jhbp.286, which has been published in final form at http://dx.doi.org/10.1002/jhbp.286. This article may be used for non-commercial purposes in accordance with Wiley Terms and Conditions for Self-Archiving.
URI: http://hdl.handle.net/10564/3327
ISSN: 18686974
Academic Degrees and number: 24601B1394
Degree-granting date: 2017-03-15
Degree name: 博士(医学)
Degree-granting institutions: 奈良県立医科大学
Appears in Collections:2016年度

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