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The following is a summary of “Clinical and Financial Validation of the International Study Group for Pancreatic Surgery (ISGPS) Definition of Post-Pancreatectomy Acute Pancreatitis (PPAP): International Multicenter Prospective Study,” published in the October 2024 issue of Surgery by Bannone et al.
In 2022, the International Study Group for Pancreatic Surgery (ISGPS) defined post-pancreatectomy acute pancreatitis (PPAP), recommending a prospective validation of the diagnostic criteria and grading system.
Researchers conducted a prospective study to validate the ISGPS definition and grading system of PPAP after pancreatoduodenectomy (PD).
They involved patients undergoing PD (n=2902) at 17 referral pancreatic centers across Europe, Asia, Oceania, and the United States, requiring 3 parameters for PPAP diagnosis. Postoperative serum hyperamylasemia/hyperlipasemia (POH) persisting on postoperative days 1 and 2, radiologic alterations consistent with PPAP, and a clinically relevant deterioration in the patient’s condition.
The results showed that 7.5% (n=218) of patients developed PPAP, with 6.3% classified as grade B and 1.2% as grade C, and POH occurred in 24.1% of patients. Hospital stays were associated with PPAP grades, no POH/PPAP 10 days (IQR 7-17), grade B 22 days (IQR 15-34), and grade C 43 days (IQR 27-54) (P<0.001). Additionally, ICU admissions were 5.4% for no POH/PPAP, 12.6% for grade B, and 82.9% for grade C (P<0.010), and hospital readmission rates were 7.3% for no POH/PPAP, 16.1% for grade B, and 18.5% for grade C (P<0.05). The costs associated with grade B and C PPAP were 2 and 11 times greater than those of an uncomplicated clinical course, respectively (P<0.001).
They concluded that the first prospective, international validation of the ISGPS definition and grading system for PPAP highlighted the relevant clinical and financial implications of this condition, emphasizing the need for routine screening in patients undergoing PD.
Source: journals.lww.com/annalsofsurgery/abstract/9900/clinical_and_financial_validation_of_the.1110.aspx
