Diagnosis And Risk Factors For Pancreatic Fistula After Radical Gastrectomy In Gastric Cancer Patients

ObjectiveTo investigate the diagnosis and risk factors for pancreatic fistula after radical gastrectomy in gastric cancer patients,and to provide a reference for the prevention and treatment of pancreatic fistula after radical gastrectomy in clinical treatment.MethodsA retrospective analysis was performed for the clinical data of 106 patients who underwent radical gastrectomy in The First Affiliated Hospital of Nanchang University from December 2017 to July 2018.The patients were divided into pancreatic fistula group and non-pancreatic fistula group,The influencing factors for pancreatic fistula were analyzed by The chi-square test or Fisher’s exact test.ResultsOf all patients,9(8.5%)had pancreatic fistula,among whom 7 had grade A pancreatic fistula,2 had grade B pancreatic fistula,and none of grade C pancreatic fistula.All of the patients were treated non-operatively.The analysis showed that age,involving pancreas and later stages between the two group(pancreatic leakage and non-pancreatic leakage)were influencing factors for pancreatic fistula after surgery(P=0.032,0.003,and P=0.035).An amylase level of ≥4000 IU/L in drainage fluid on day 1 after surgery had a certain predictive value for the development of pancreatic fistula after surgery,the sensitivity and specificity were 55.5% and 94.8%.ConclusionPatients with an age of ≥65 years,involving pancreas,later stages were susceptible to pancreatic leakage.An amylase level of ≥4000 IU/L in drainage fluid on day 1 after surgery had a certain predictive value for the development of pancreatic fistula after surgery,Early discovery and combination therapy would benefit for prognosis in patients with pancreatic leakage.