Analysis Of Related Risk Factors For Pancreatic Fistula (PF) After Pancreaticoduodenectomy (PD)

Objective:To explore the related risk factors of pancreatic fistula(POPF)after pancreaticoduodenectomy(PD),and to provide further guidance and prevention measures for clinical treatment.Methods:Clinical data about 162 consecutive patients who underwent PD in China-Japan Union Hospital from 2013.1-2017.6 were recorded retrospectively.The risk factors for pancreatic fistula after pancreatoduodenectomy generally included age,gender,history of upper abdominal surgery,hypertension,coronary heart disease,diabetes,total bilirubin on admission,total bilirubin preoperatively,preoperative PTCD,operation time,pancreatic and intestinal anastomosis,intraoperative blood loss,pancreatic texture,pancreatic duct diameter,whether or not with chronic pancreatitis,tumor nature and so on.Univariate analysis and multivariate logistic regression analysis were used to estimate relative risks.Results:The incidence of pancreatic fistula after pancreatoduodenectomy was 12.96%.Of the 162 patients,POPF of grade B in 15 patients(9.26%),grade C in 6 cases(3.70%).Univariate analysis showed that pancreatic duct diameter(P = 0.008),pancreatic texture(P = 0.039),total bilirubin(P = 0.047),diabetes(P = 0.001)were risk factors of pancreatic fistula after pancreaticoduodenectomy.Logistic regression analysis showed that pancreatic duct diameter(P =0.022)and diabetes(P =0.008)were independent risk factors of pancreatic fistula after pancreaticoduodenectomy.Conclusion:Pancreatic diameter and diabetes mellitus are independent risk factors of pancreatic fistula after pancreatoduodenectomy,and pancreatic texture and preoperative total bilirubin may also be related to the occurrence of pancreatic fistula.