The Clinical Analysis Of Related Risk Factors About Early Complications After Pancreaticoduodenectomy Surgery

Objective: to discuss the related risk factors which influence early complications after Pancreaticoduodenectomy surgery(PD for short), so as to provide an advice for clinical treatments during the perioperative period of PD.Method:to make a retrospective analysis about the clinical date of the department of hepatobiliary surgery, the first affiliated hospital of Kunming Medical University(the74resident patients from June,2007to June,2012which were incorporated according to the exclusion criteria). During the74patients, male accounts for55(74.3%) while female accounts for19(25.7%) only. The age span is21to76years old, the average age of the patients is55. The basic disease in this study includes pancreatic cancer(30cases),cholangiocarcinoma(15cases),pancreas ampulla carcinoma (8cases),duodenum carcinoma(18cases),pyloricantrum adenocarcinoma involving pancreas (2cases) and chronic pancreatitis (leases).Subjects were divided into15indices research object groups according to age(=65)、sex、diabetes,Duration ofjaundice (=21days)、Hb (<110g/L)、TB=171umol/L、 ALB=35g/L、Abnormal prothrombin time、Operation time=7h、quantity of bleeding=1000ml、manner of pancreatojejunostomy、The biliary diameter=1.5cm、the diameter of the pancreatic duct>3mm、pancreatic fistula、postoperative hemorrhage。We designed a table According to the Factors which may influence Early postoperative complications (such as blood loss、Pancreatic fistula、Biliary fistula、gastric emptying dysfunction abdominal infection、pulmonary infections) by Univariate analysis of the two classifications. above all, analyzed meaningful items(P<0.05) by Logistic regression analysis. Evaluating the incidence of PD postoperative complications and their related risk factors. Results:1.there are25cases exist complications in one month following the PD surgery among the74patients,which accounts for33.8%in total.That is:pancreatic fistula (7cases), abdomen bleeding (4cases), alimentary tract hemorrhage (4cases), biliary fistula (3cases), delayed gastric emptying (4cases), lung infection (7cases), abdomen infection (5cases), dying from MODS (2cases), and another two cases have been applied surgery treatment as the bleeding complications in24hours after the primary surgery.2. the four element (Duration of jaundice、TB、PT、Operation time)are independent risk factors induce to the postoperative hemorrhage which is determined by singular factor analysi(P<0.05). Duration of jaundice, Hb, blood loss are the independent factors of the Pancreatic fistula (P<0.05).Hb and The biliary diameter are the independent factors of the Biliary fistula (P<0.05).Age and the Operation time are the independent factors of the pulmonary infections (P<0.05). blood loss, the Pancreatic fistula and Operation time are the independent factors of abdominal infection (P<0.05).Duration of jaundiceand the diabetes are the independent factors of the gastric emptying dysfunction (P<0.05).these Independent risk factor for multivariate analysis by logistic regression analysis forward can conclude that there are four main risk factors(TB,Duration of jaundice,blood loss and the Operation time) related to the complications after Pancreaticoduodenectomy surgery.Conclusion:Jaundice duration,the amount of blood loss,Operation time, levels of total bilirubin were the major risk factors of complication incidence.