Organ System Grade I-Asymptomatic and self-limiting Grade II-Symptomatic and medical treatment Grade III-Invasive intervention Grade IV-ICU care or return to operating room Gastrointestinal System
Anastomotic failure Sub-clinical, afebrile, radiologic diagnosis (0) Antibiotics, febrile (0) Percutaneous drainage (0) Reoperation (3) Fistula Sub-clinical, afebrile, radiologic diagnosis (0) Antibiotics, febrile (0) Percutaneous drainage (0) Reoperation (3) Pancreatic fistula Elevated enzymes in drains (0) TPN and somatostatin (0) Percutaneous drainage (0) Reoperation (1) Pancreatitis Elevated enzymes (4) ≤3 Ranson’s score (4) 4–6 Ranson’s score (0) Reoperation/ICU (1) Bile leak Bile only in drain (0) Bile in drain, febrile (2) Percutaneous drainage (0) Reoperation (1) Chyle leak Transient (1) Prolonged 1 week (0) Cease prior to discharge (0) Persist past hospital discharge (0) Prolonged ileus N/G (0) N/G > 2 weeks (1) N/G >3 weeks (0) Persist past hospital discharge (0) Small bowel obstruction Abdominal pain (0) Abdominal pain, N/G reinsertion (0) Repeat radiologic studies (0) Reoperation (1) Nausea/vomiting Transient vomiting (0) Vomiting, anti-emetics (7) Vomiting, IV therapy (4) Vomiting with surgical intervention or ICU (1) Diarrhea Transient <2 days (0) Tolerable, but >2 days (1) Intolerable, IV therapy (0) Dehydration prolonged IV therapy (0) Ascites Mild (0) Fluid restriction (0) Symptomatic, percutaneous tap (0) Compromising vital function, ICU care (0)