Ajith K. Siriwardena
7006352137
Publications - 1
Clinical and Financial Validation of the International Study Group for Pancreatic Surgery (ISGPS) Definition of Post-pancreatectomy Acute Pancreatitis (PPAP): International Multicenter Prospective Study
Alice Cattelani
Masafumi Nakamura
Werner Hartwig
Asahi Sato
Attila Oláh
Christopher M. Halloran
Saxon Connor
Roland Andersson
Jakob R. Izbicki
Martin Loos
Marc G. Besselink
Markus W. Büchler
Cristina Ferrone
Thilo Hackert
Roberto Salvia
Daniel Kilburn
Keith D. Lillemoe
Oliver Strobel
Jens Werner
Mustapha Adham
Charles Vollmer
Nicholas J. Zyromski
Gaetano Corvino
Yi Miao
Massimo Falconi
Christos Dervenis
John P. Neoptolemos
Shailesh V. Shrikhande
Elisa Bannone
Nicolò Pecorelli
Stefano Partelli
Fraser Jeffery
Daniel Halloran
Marco Montorsi
Harish Lavu
Alessio Marchetti
Valentina Andreasi
Francesca Fermi
Domenico Tamburrino
Alessandro Esposito
Giuseppe Malleo
Manish Bhandare
Kaival Gundavda
Kuirong Jiang
Zipeng Lu
Savio George Barreto
Luca Gianotti
Alessandro Zerbi
Helmut Friess
Jie Yin
Rosa Klotz
Daniela Merz
Christoph Michalski
Ulla Klaiber
Gennaro Nappo
Christopher L. Wolfgang
Giovanni Marchegiani
Maximillian Bockhorn
Ugo Boggi
Bodil Andersson
Robert Padbury
Ajith K. Siriwardena
Abe Fingerhut
Olivier R.C. Busch
Giuseppe Kito Fusai
Kevin Christopher Conlon
Alberto Manzoni
Dejan Radenkovic
Michael Sarr
Kyoichi Takaori
Naoki Ikenaga
Pasquale Scornamiglio
Mohammad Abu Hilal
Charles J. Yeo
Marc G. Besselink
Publication Name: Annals of Surgery
Publication Date: 2026-07-01
Volume: 284
Issue: 1
Page Range: e12-e21
Description:
Objective: – To validate the International Study Group for Pancreatic Surgery (ISGPS) definition and grading system of post-pancreatectomy acute pancreatitis (PPAP) after pancreatoduodenectomy (PD). Background: – In 2022, the ISGPS defined PPAP and recommended a prospective validation of its diagnostic criteria and grading system. Methods: – This was a prospective, international, multicenter study including patients undergoing PD at 17 referral pancreatic centers across Europe, Asia, Oceania, and the United States. PPAP diagnosis required the following 3 parameters: (1) postoperative serum hyperamylasemia /hyperlipasemia (POH) persisting on postoperative days 1 and 2, (2) radiologic alterations consistent with PPAP, and (3) a clinically relevant deterioration in the patient’s condition. To validate the grading system, clinical and economic parameters were analyzed across all grades. Results: – Among 2902 patients undergoing PD, 7.5% (n=218) developed PPAP (6.3% grade B and 1.2% grade C). POH occurred in 24.1% of patients. Hospital stay was associated with PPAP grades [no POH/PPAP 10 days [interquartile range (IQR): 7–17] days, grade B 22 days (IQR: 15–34) days, and grade C 43 days (IQR: 27–54) days; P<0.001], as well as intensive care unit admission (no POH/PPAP 5.4%, grade B 12.6%, grade C 82.9%; P<0.010), and hospital readmission rates (no POH/PPAP 7.3%, grade B 16.1%, grade C 18.5%; P<0.05). Costs of grade B and C PPAP were 2 and 11 times greater than uncomplicated clinical courses, respectively (P<0.001). Conclusions: – This first prospective, international validation study of the ISGPS definition and grading system for PPAP highlighted the relevant clinical and financial implications of this condition. These results stress the importance of routine screening for PPAP in patients undergoing PD.
Open Access: Yes
