Analysis Of Risk Factors Of Duodenal Stump Fistula After Gastrectomy For Gastric Cancer

Objective: Duodenal stump fistula(DSF)is one of the most severe complications after gastrectomy for gastric cancer.According case retrospective study,the relevant risk factors of duodenal stump fistula after gastric cancer surgery were selected,which were used as risk indicators to predict duodenal stump fistula and provided theoretical basis for the clinical prevention of duodenal stump fistula.Methods: 521 patients who involving their surgery performed in Dalian Municipal central Hospital Affiliated of Dalian Medical University between May 2013 and December 2017 were involved in this study.All of them were confirmed by pathological diagnosis after the surgery and 29 of them were diagnosed with duodenal stump fistula.Clinical datas were collected including basic information(name,age,gender,period of hospitalization),preoperative status(NRS 2002,ASA score,pre-operative albumin levels,pre-operative lymphocytes number,pyloric obstruction);Perioperative diseases(diabetes,heart disease,hypertension,liver cirrhosis,chronic obstructive pulmonary disease COPD);Surgery and tumor pathological information(type of archenteric reconstruction,method of gastrectomy,high pTNM stage,tumor diameter,tumor site,and pathological differentiation degree).All datas were used to conduct univariate and multivariate analysis of the risk factors for duodenal stump fistula.Results: According to monovariate analysis,NRS2002?3,ASA score ? 3,hypoproteinemia,heart disease,liver cirrhosis,pTNM stage were found to be DSF-specific risk factors.According to multivariate analysis,NRS 2002?3,liver cirrhosis and pTNM stage were found to be closely related to DSF development.Conclusion: Duodenal stump fistula(DSF)is one of the most severe complications after gastrectomy for gastric cancer.NRS score?3,liver cirrhosis and pTNM stage should be regarded as important risk indicators.