Impact of preoperative asymptomatic renal dysfunction on clinical course after pancreatoduodenectomy.

• Material Type: 博士論文
• Title: Impact of preoperative asymptomatic renal dysfunction on clinical course after pancreatoduodenectomy.
• Author/Editor: Nagai, Minako; Sho, Masayuki; Akahori, Takahiro; Tanaka, Toshihiro; Kinoshita, Shoichi; Nishiofuku, Hideyuki; Nishiwada, Satoshi; Ohbayashi, Chiho; Kichikawa, Kimihiko; Nakajima, Yoshiyuki
• Author Heading: Nagai, Minako; Sho, Masayuki; Akahori, Takahiro; Tanaka, Toshihiro; Kinoshita, Shoichi; Nishiofuku, Hideyuki; Nishiwada, Satoshi; Ohbayashi, Chiho; Kichikawa, Kimihiko; Nakajima, Yoshiyuki
• Publication, Distribution, etc.: John Wiley & Sons, Inc.
• Publication Date: 2015-11
• Publication Date (W3CDTF): 2015-11
• Alternative Title: 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
• Periodical title: Journal of hepato-biliary-pancreatic sciences
• No. or year of volume/issue: 22 11
• Volume: 22
• Issue: 11
• Pages: 810-818
• ISSN (Periodical Title): ISSN : 1868-6974
• Degree grantor/type: 奈良県立医科大学
• Date Granted: 2017-03-15
• Dissertation Number: 乙第1394号
• Degree Type: 博士（医学）
• Text Language Code: eng
• Subject Heading: Pancreatoduodenectomy; Postoperative complication; Prognosis; Renal dysfunction; Surgery
• Target Audience: 一般
• Note (General): type:Thesis; 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.; 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.; identifier:Journal of hepato-biliary-pancreatic sciences Vol.22 No.11 p.810-818 (2015 Nov); identifier:18686974; identifier:http://ginmu.naramed-u.ac.jp/dspace/handle/10564/3327; identifier:Journal of hepato-biliary-pancreatic sciences, 22(11): 810-818
• Source: fulltext; http://ginmu.naramed-u.ac.jp/dspace/bitstream/10564/3327/1/01_%e4%b9%991394%e6%9c%ac%e6%96%87%e3%81%ae%e8%a6%81%e6%97%a8.pdf; http://ginmu.naramed-u.ac.jp/dspace/bitstream/10564/3327/2/02_%e4%b9%991394%e5%af%a9%e6%9f%bb%e8%a6%81%e6%97%a8.pdf; http://ginmu.naramed-u.ac.jp/dspace/bitstream/10564/3327/3/03_%e4%b9%991394%e6%9c%ac%e6%96%87.pdf
• Access Restrictions: インターネット公開
• Related Material (DOI): 10.1002/jhbp.286
• Periodical Title (NCID): AA12507209; https://ci.nii.ac.jp/ncid/AA12507209
• Data Provider (Database): 国立情報学研究所 : 学術機関リポジトリデータベース（IRDB）（機関リポジトリ）; https://irdb.nii.ac.jp
• Original Data Provider (Database): 奈良県立医科大学 : 奈良県立医科大学機関リポジトリ GINMU