The International Study Group on Pancreatic Fistula (ISGPF/ISGPS) grades postoperative pancreatic fistula (POPF) into three grades. A patient has a drain amylase >3× upper limit of normal on postoperative day 3, requires prolonged drainage only, and has no clinical consequences. This corresponds to which grade?
- A Grade B
- B Biochemical leak (formerly Grade A) ✓
- C Grade C
- D Not classified as POPF
Correct answer: B. Biochemical leak (formerly Grade A)
Explanation
The updated 2016 ISGPS classification renamed POPF Grade A as 'biochemical leak' — it is defined by drain amylase >3× the upper limit of serum normal on postoperative day 3, with no clinical impact, no change in management, and no prolonged clinical consequence. Grade B requires a change in management (prolonged drain, parenteral nutrition, or antibiotics). Grade C involves clinically significant events requiring re-operation, ICU admission, or organ failure.
Reference: Bailey & Love's Short Practice of Surgery, 27th ed.
High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP
Written and medically reviewed by the StethoPrep medical team.