Pancreatic fistula after duct-to-mucosa pancreaticojejunostomy
10.3760/cma.j.issn.1007-631X.2009.03.004
- VernacularTitle:端侧胰管空肠黏膜-黏膜吻合术后胰瘘的危险因素分析
- Author:
Jiawen DU
;
Dongpo PEI
;
Linping HUANG
;
Zhengkang WANG
;
Wu NING
- Publication Type:Journal Article
- Keywords:
Pancreatieoduodenectomy;
Postoperative complications;
Pancreatic fistula;
Riskfactors
- From:
Chinese Journal of General Surgery
2009;24(3):185-188
- CountryChina
- Language:Chinese
-
Abstract:
Objective To investigate the risk factors for pancreatic fistula after duct-to-mucosa pancreaticojejuuostomy (PD). Methods The clinical data of 101 cases undergoing duct-to-mucosa PD in our hospital from January 1994 to January 2008 were reviewed retrospectively. Results The incidence of pancreatic fistula was 9.9% (10/101). Univariate analysis showed level of preoperative jaundice(χ2=5.814, P= 0.016) , duration of jaundice (χ2= 4.17, P = 0.041 ), texture of the remnant pancreas (χ2=5.286, P = 0.021 ), diameter of pancreatic duct (χ2= 4.165, P = 0.041 ), blood loss during operation (χ2=5.273, P=0.022) were significantly associated with pancreatic fistula after duct-to-mucosa PD. Multivariate analysis regression revealed that texture of the remnant pancreas (OR = 13.355, P = 0.023), level of preoperative jaundice (OR = 12.126, P = 0.006), blood loss during operation (OR = 5.92, P =0.032 ) were independent risk factors. Logistic regression equation was as following: P=1/[<1+e-(-6.378+2.592 texture of the remrant pancress + 2.495 level of preopetative jaundice + 1.778 blood loss during operative)>]. The accuracy of the logistic equation was 92.1%. Conclusion Texture of the remnant pancreas, level of preoperative jaundice, blood loss during operation were the independent risk factors for the occurrence of PD after duct-to-mucosa PD. Improvement of operative technique and reduction of blood loss can decrease the incidence of pancreatic fistula.
