Analysis Of Risk Factors For Pancreatic Fistula After Pancreaticoduodenectomy

ObjectiveTo Explore the risk factors for pancreatic fistula after pancreaticoduodenectomy(PD).MethodsThe the clinical data of158patients receiving PD in our hospital between June2008and June2013were studied.And the potential perioperative factors forpancreatic fistula were analyzed with univariate and multivariate logistic regressionmodel.According to gender,age,preoperative bilirubin level,preoperative albuminlevels, BMI,operation time,intraoperatie blood loss,pancreatic duct diameter,pancreatic texture,whether prophylactic use of somatostatin were divided into twogroups;According to the different methods of pancreatic bowel anastomosis,dividedinto invaginated/bundled pancreaticojejunostomy group and Prolene suture full-thickness end-to-side pancreaticojejunostomy group.SPSS17.0statistical softwarewas used to analysis, univariate analysis according to the chi-square test and Fisher’sexact probability method, the inspection standards a=0.05.If P＜0.05,we believe that the difference was statistically significant. Logistic regression analysis was carriedout on the statistically significant factors,we believe these factors were independentrisk factors which left in the Logistic regression model.ResultsThe incidence of postoperative pancreatic fistula was9.5%(15/158) in thegroup of patients, and the mortality associated with pancreatic fistula was13.3%.Theinvaginated/bundled anastomosis in the51cases,happen9cases of pancreatic fistula;The Prolene suture full-thickness end-to-side anastomosis in the107cases, happen6cases of pancreatic fistula.Univariate analysis showed that the occurrence ofpancreatic fistula has no obvious relationship with gender,age,preoperative bilirubinlevel, preoperative albumin levels,operation time,intraoperatie blood loss,pancreaticduct diameter,whether prophylactic use of somatostatin, occurrence of pancreaticfistula has obvious relationship with BMI,pancreatic texture,different methods ofpancreatic bowel anastomosis.ConclusionBMI>25is a risk factor for pancreatic fistula after PD,the relative risk (RR) is4.04;the soft pancreas is also a risk factor for pancreatic fistula after PD,the relativerisk (RR) is5.16.Interrupted suture would increase the pancreatic fistula rate afterPD,but the Prolene suture full-thickness end-to-side anastomosis could reduce thepancreatic fistula rate after PD,and the procedure is simple.