Analysis of risk factors for reoperation after pancretoduodenectomy
10.3877/cma.j.issn.2095-3232.2014.01.008
- VernacularTitle:胰头十二指肠切除术后患者再手术的危险因素分析
- Author:
Dong CHEN
1
;
Weikai XIAO
;
Liang DENG
;
Jiaming LAI
;
Baogang PENG
;
Lijian LIANG
Author Information
1. 中山大学附属第一医院肝胆外科
- Keywords:
Pancreaticoduodnectomy;
Reoperation;
Risk factors;
Blood loss,surgical;
Diabetes mellitus
- From:
Chinese Journal of Hepatic Surgery（Electronic Edition）
2014;(1):29-32
- CountryChina
- Language:Chinese
-
Abstract:
Objective To investigate the risk factors for reoperation after pancreaticoduodenectomy (Whipple). Methods Clinical data of 339 patients who underwent Whipple in the First Afifliated Hospital of Sun Yat-sen University from January 2000 to December 2009 were analyzed retrospectively. The informed consents of all patients or relatives were obtained and the ethical committee approval was received. There were 206 males and 133 females with age ranging from 1 to 86 years old and the median age of 55 years old. According to whether the patients received reoperation after operation, they were divided into reoperation group (n=24) and non-reoperation group (n=315). The reoperation of patients and its risk factors were analyzed. The relations between reoperation and clinical parameters were analyzed using Chi-square test and the risk factors for reoperation were analyzed using Logistic regression analysis. Results The reoperation rate of patients was 7.1%(24/339). The main causes of reoperation included abdominal bleeding (n=8, 5 cases were complicated with pancreatic fistula), upper gastrointestinal bleeding (n=7, 2 cases were complicated with pancreatic ifstula), pancreatic ifstula complicated with abdominal infection (n=2), biliary leakage (n=1) and wound rupture (n=6). In 24 patients receiving reoperation, 9 cases were related with pancreatic ifstula. Four out of 5 death cases were with pancreatic ifstula. The reoperation was related to preoperative diabetes, intraoperative blood loss (χ2=5.588, 4.565;P<0.05). Preoperative diabetes, intraoperative blood loss>400 ml were independent risk factors for reoperation after Whipple (OR=5.80, 2.74; P<0.05). Conclusions The main causes of reoperation after Whipple are pancreatic ifstula and wound rupture. Preoperative diabetes, intraoperative blood loss>400 ml are independent risk factors for reoperation after Whipple.
