Clinical and Financial Validation of the International Study Group for Pancreatic Surgery (ISGPS) Definition of Post-pancreatectomy Acute Pancreatitis (PPAP): International Multicenter Prospective Study.
Publication/Presentation Date
7-1-2026
Abstract
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.
Volume
284
Issue
1
First Page
12
Last Page
12
ISSN
1528-1140
Published In/Presented At
Bannone, E., Cattelani, A., Corvino, G., Marchetti, A., Andreasi, V., Fermi, F., Partelli, S., Pecorelli, N., Tamburrino, D., Esposito, A., Malleo, G., Bhandare, M., Gundavda, K., Jiang, K., Lu, Z., Yin, J., Lavu, H., Klotz, R., Merz, D., Michalski, C., … International Study Group for Pancreatic Surgery (ISGPS) (2026). Clinical and Financial Validation of the International Study Group for Pancreatic Surgery (ISGPS) Definition of Post-pancreatectomy Acute Pancreatitis (PPAP): International Multicenter Prospective Study. Annals of surgery, 284(1), e12–e21. https://doi.org/10.1097/SLA.0000000000006569
Disciplines
Business Administration, Management, and Operations | Health and Medical Administration | Management Sciences and Quantitative Methods
PubMedID
39435540
Department(s)
Administration and Leadership
Document Type
Article