The Clinical Observation Of Early Complications After Distal Pancreatectomy

Objective: to investigate the risk factors which influence early complications after distal pancreatectomy. So as to provide an advice for clinical treatments during the perioperative of DP.Methods: To make a retrospective analysis about the clinical date of Fujian Medical University attached Union Hospital(the 60 resident patients from April 2008 to November 2014, which were incorporated according to the exclusion criteria). Subjects were divided into 18 indices research object groups according to age, sex, BMI, PNI, hypertension, diabetes, hyperlipidemia, preoperative CT value of normal pancreas tissues, pathology, operation time, blood loss, operation method(open or laparoscopic, spleen-preserved or spleen-resection), the degree of tissue adhesion, DGE after operation, postoperative pancreatic fistula, abdominal infection, pulmonary infection. We designed a table according to the factors which may influence early postoperative complications(such as PF, abdominal infection, DGE, pulmonary infection) by univariate analysis of the two classifications. Above all, analyzed meaningful items(P<0.05) by Logistic regression analysis. Evaluating the incidence of DP postoperative complications and the related risk factors.Results: 1. There were 45 cases exist complications following the DP surgery among the 60 patients, which accounts for 75.0% in total. That is: PF(42 cases, account for 70.0%), abdominal infection(19 cases, account for 31.7%), DGE(30 cases, account for 50.0%), pulmonary infection(13 cases, account for 21.7%), dying from severe abdominal infection and hepatic failure(1 cases, account for 1.7%).2. Female abdominal infection are independent risk factors of the PF(P<0.05). Age over 60 years and abdominal infection are independent factors of the CR-PF(P<0.05). Age over 60 years, diabetes, tissue adhesion is obviously, DGE, PF and CR-PF areindependent factors of the abdominal infection(P<0.05). Age over 60 years, malignant tumor, tissue adhesion is obviously and abdominal infection are independent factors of DGE(P<0.05). Operation time over 4h, blood loss over 300 ml, PF and abdominal infection are independent factors of the pulmonary infection(P<0.05). These independent risk factors for multivariate analysis by logistic regression forward can conclude that the correlation between risk factors of complications after DP surgery: female > blood loss over 300 ml > malignant tumor > age over 60 years > tissue adhesion is obviously > diabetes > operation time over 4h.Conclusion: the correlation between risk factors of complications after DP surgery: female > blood loss over 300 ml > malignant tumor > age over 60 years > tissue adhesion is obviously > diabetes > operation time over 4h.