BACKGROUND: Postoperative pancreatic @entity292 (POPF) is the most important complication after pancreatic surgery. In 2005, the International Study Group of Pancreatic Surgery (ISGPS) introduced a standardized POPF definition with severity grading from A to C. In recent years, @entity5173 ( @entity5173 ) has become the standard of care for symptomatic postoperative fluid collections or undrained POPF. From the original definition, it is unclear whether @entity5173 is categorized as POPF grade B or C. Therefore, international authors shift @entity5173 between grades B and C. The aim of the study was to analyze @entity1 with @entity5173 (proposed new grade B) versus @entity1 who underwent reoperation (grade C) for POPF. METHODS: Between 2005 and 2013, all @entity1 undergoing pancreatic resection were analyzed regarding POPF grade A-C. Demographic data, type of operation, @entity260 , therapies and outcome were examined with focus on @entity5173 versus reoperation. RESULTS: Of the 2,955 @entity1 included, 403 developed POPF (13.6%). Among all POPF, 11% were grade A, 17% grade B (clinically symptomatic without @entity5173 ), and 72% grade C. These @entity1 underwent either @entity5173 (n  =  165) or reoperation (n  =  123). @entity1 with @entity5173 had an average hospital stay of 33  days and POPF-associated mortality of 0%. This was strikingly different from @entity1 undergoing reoperation with a hospital stay of 47  days and POPF-associated mortality of 37% (P  <  .0001). CONCLUSION: After 10  years of the ISGPS classification, there is a clear-cut outcome difference between @entity1 undergoing POPF-associated @entity5173 or reoperation. We propose assigning all @entity1 undergoing @entity5173 as POPF grade B. @entity1 undergoing reoperation should definitely remain within category C.

Postoperative pancreatic XXXX : We need to redefine grades B and C.

@entity1 :: ('9606', 'Species') :: ['Patients', 'patients'] @entity5173 :: ('MESH:D065634', 'Disease') :: ['ID', 'interventional drainage'] @entity292 :: ('MESH:D005402', 'Disease') :: ['fistula'] @entity260 :: ('MESH:D011183', 'Disease') :: ['postoperative complications']
@entity292 :: (MESH:D005402,Disease) :: ['fistula']
