The International Study Group of Pancreatic Surgery (ISGPS) grades postoperative pancreatic fistula (POPF) after pancreaticoduodenectomy. Which grade is defined by pancreatic fistula requiring percutaneous or endoscopic intervention but without re-operation?
- A Grade A (biochemical leak)
- B Grade B ✓
- C Grade C
- D Grade D
Correct answer: B. Grade B
Explanation
The 2016 revised ISGPS definition classifies POPF as: biochemical leak (Grade A, formerly not a true fistula — drain amylase >3× upper normal on day 3, no clinical impact), Grade B (clinically relevant fistula requiring change in management including NGT, TPN, or percutaneous/endoscopic intervention but not re-operation), and Grade C (fistula requiring re-operation or leading to organ failure or mortality). Grade B accounts for the majority of clinically relevant fistulas.
Reference: Bailey & Love's Short Practice of Surgery, 27th ed.
High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP
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