Risk factors analysis of pancreatic fistula after pancreaticoduodenectomy
10.3760/cma.j.issn.1673-9752.2018.07.016
- VernacularTitle:胰十二指肠切除术后胰瘘发生的危险因素分析
- Author:
Hanpeng DU
1
;
Wei CHEN
;
Li HUANG
;
Kunsong ZHANG
;
Lijian LIANG
;
Jiaming LAI
Author Information
1. 511400,南方医科大学附属何贤纪念医院广州市番禺区何贤纪念医院普通外科
- Keywords:
Pancreatic diseases;
Pancreatic neoplasms;
Pancreatic cancer;
Pancreaticoduodenectomy;
Pancreatic fistula;
Pancreaticojejunostomy;
Risk factors
- From:
Chinese Journal of Digestive Surgery
2018;17(7):724-728
- CountryChina
- Language:Chinese
-
Abstract:
Objective To investigate the risk factors of pancreatic fistula after pancreaticoduodenectomy.Methods The retrospective case-control study was conducted.The clinicopathological data of 310 patients who underwent pancreaticoduodenectomy in the First Affiliated Hospital of Sun Yat-Sen University between January 2011 and December 2015 were collected.Observation indicators:(1) follow-up situations;(2) risk factors analysis of pancreatic fistula after pancreaticoduodenectorny.Follow-up using outpatient examination and telephone interview was performed to detect occurrence of pancreatic fistula and pancreatic fistula-induced rehospitalization or death up to June 2016.The univariate and multivariate analyses were respectively done using the chi-square test and logistic regression model.Results (1) Follow-up situations:310 patients were followed up for 6-60 months,with a median time of 31 months.During the follow-up,65 patients were complicated with pancreatic fistula,including 59 in grade B and 6 in grade C.Twenty-four patients received conservative treatment,and 41 received B ultrasound-guided catheter drainage.Of 65 patients,63 were improved and then discharged form hospital;2 in grade C of pancreatic fistula died of pancreatic fistula-related complications.(2) Risk factors analysis of pancreatic fistula after pancreaticoduodenectomy:univariate analysis showed that combined hypertension,cases with pancreaticoduodenectomy,operation time and pancreaticojejunostomy method were related factors affecting pancreatic fistula after pancreaticoduodenectomy (x2 =5.986,13.006,9.025,21.561,P＜0.05).The multivariate analysis showed that combined hypertension,operation time ＞ 6 hours and end-to-end telescopic pancreaticojejunostomy or biuding pancreaticojejunostomy were independent risk factors affecting pancreatic fistula after pancreaticoduodenectomy (Odds ratio =2.465,1.880,2.719,6.190,95％ confidence interval:1.253-4.850,1.025-3.448,1.254-5.894,2.309-16.592,P＜0.05).Conclusion The combined hypertension,operation time ＞ 6 hours and end-to-end telescopic pancreaticojejunostomy or binding pancreaticojejunostomy are independent risk factors affecting pancreatic fistula after pancreaticoduodenectomy.
