The Risk Factors Analysis Of Postoperative Complications After Pancreaticoduodenectomy

Objective:Multi-factor analysis of pancreaticoduodenectomy(PD) risk factors for postoperative complications,and clinical implementation of PD to provide the basis of the indications and technical decision-making to guide preoperative preparation and postoperative control.Methods:Retrospective analyz the clinical data of 146 routine pancreaticoduodenectomy(PD) patients from January 1998 to August 2008 of First Hospital of Shanxi Medical University,, and through univariate and multivariate analysis to evaluate the situation and related risk factors of their operation complications.146 cases were performed in patients with standard PD,the average age of 57.3 years old,according to two pancreatic lesion group(58 cases) and group periampullary duodenum,ampulla and common bile duct malignancy(88 cases).Results:(1) 146 routine PD patients,there were 54 cases of postoperative complications(39.7%), 18 cases of infectious complications(12.3%),multiple organ dysfunction in 4 patients(2.7%),15 cases of delayed gastric emptying(10.3%),10 cases of bleeding complications(6.8%),seven cases of pancreatic fistula(4.8%).Periampullary total number of complications than the pancreas group(P＜0.05).(2) Multivariate analysis showed that The independent risk factors related to the postoperative complications included the number of days of preoperative jaundice,preoperative levels of ALB and coexisting vital organ disorders;risk factors for infection were age,an important organ system complications;the risk factors of delayed gastric emptying including the preoperative level of direct bilirubin and ALB;ALB levels is the risk factor of bleeding complications;the risk factors of pancreatic fistula are the main pancreatic duct diameter, number of days of preoperative jaundice,and there is coexisting vital organ disorders;the number of days of preoperative jaundice,Cr levels are the risk factors of multiple organ dysfunction(MODS).Conclusion:The number of days of preoperative jaundice,preoperative ALB levels,coexisting vital organ disorders,age,preoperative total bilirubin,direct bilirubin,Cr levels and the main pancreatic duct diameterare the independent risk factors,of various kinds of complications after PD...