Study On The Related Risk Factor Of Pancreatic Fistula After Pancreatic Tail Resection

Objective Pancreatic cancer is the most common malignant tumor in the digestive tract,the prognosis of patients is poor,and it is a serious threat to the lives and health of patients.In recent years,with the continuous development of medical technology,pancreatic cancer treatment has made great progress,but surgical treatment is still the only way to cure pancreatic cancer,and postoperative pancreatic fistula is the most serious complications after surgery,a serious threat to the quality of life of patients and the duration of life.Therefore,the study of postoperative pancreatic fistula related risk factors has great significance for the prevention and treatment of pancreatic cancer after pancreatic surgery.Methods This study was to retrospectively analyze the clinical data of patients with pancreatic cancer diagnosed at the Pancreatic Center of the Second Affiliated Hospital of Nanjing Medical University from January to December 2016.The clinical data of patients with pancreatic body resection were collected by linear cutting closure Patient indicators include gender,age,diabetes mellitus,body mass index,preoperative albumin,pancreas neck thickness,surgical procedure,operation time,blood loss,pancreatic texture,pathological type,to explore the use of linear cutting closure treatment of pancreatic stump pancreatic fistula risk factors.The risk factors of pancreatic fistula were analyzed by single factor analysis,and the possible risk factors were further analyzed by multivariate logistic regression analysis to predict the risk factors of postoperative pancreatic fistula.Results A total of 24 patients underwent pancreatic tail resection were enrolled in this study.Eight patients were treated with pancreatic fistula and the rate of pancreatic fistula was 33.33%.There were 6 cases of biochemical leakage,2 cases of grade B pancreatic fistula,Fistula The results of univariate analysis showed that gender(male vs female,p = 0.558),age(?65 years vs<65 years,p = 0.317),whether diabetes(yes VS no,p = 0.477),body mass index(>24 kg/m2 VS<24 kg/m2,p=0.525),preoperative albumin(>35 g/L VS<35 g/L.p=1.000),surgery procedure(retention of spleen VS without retention of spleen,p=0.439),operation time(?3h VS<3h,p=0.770),blood loss during surgery(?200 mL VS<200 mL,p=1.000),pathological type(benign VS malignant,p=0.148),the difference was not statistically significant(p<0.01),while the thickness of the neck of pancreas(mm=12 VS<12 mm,p<0.001)and pancreatic texture(soft VS hard,p=0.076),the difference was statistically significant.Multivariate logistic regression analysis showed that postoperative pancreatic fistula was associated with pancreatic neck thickness(p<0.05),but not with pancreatic texture(p>0.05).Conclusion(1)In this study,24 cases of pancreatic fistula,pancreatic fistula occurred in 33.33%,and the incidence of pancreatic fistula was similar to that reported in the literature.(2)Univariate analysis showed that gender,age,diabetes mellitus,body mass index,preoperative albumin,operation mode,operation time,blood loss and pathological type were not the risk factors of postoperative pancreatic fistula.(3)Univariate analysis showed that pancreatic texture and pancreatic neck thickness were potential risk factors for postoperative pancreatic fistula.(4)Logistic regression analysis showed that pancreatic neck thickness was an independent risk factor for postoperative pancreatic fistula and could be used for the prediction of postoperative pancreatic fistula.