Multivariate Analysis Of Duodenal Stump Fistula After Gastric Cancer Operation

Objective:To analyze the various risk factors of duodenal stump fistula(DSF)after gastric cancer surgery,and to provide a theoretical basis for reducing the occurrence of postoperative duodenal stump fistula.Methods: A retrospective case-control study was conducted to collect clinical and pathological data from all patients undergoing gastro-intestinal surgery admitted to the First Affiliated Hospital of Wannan Medical College from March 2015 to November 2017.The required cases were finally obtained in 511 cases that met the inclusion criteria.The data of 30 patients with duodenal fistula after operation of gastric cancer were used as the study group.The data of 481 patients without duodenal fistula were used as the control group,and the age,sex,etc.of the patients were analyzed using SPSS23.0 software.Univariate analysis of risk factors associated with DSF(chi-square test,t-test,rank sum test),and multivariate logistic regression analysis of risk factors with significant differences,P<0.05 was considered significant difference,Statistically significant.Results: 1.Of the 511 patients with gastric cancer included in the study,duodenal stump fistula occurred after operation.The incidence of duodenal stump fistula was 5.9%,and 2 of the patients with DSF died.DSF The case fatality rate was 6.7%.2.The results of single factor analysis can be obtained: the patient's gender,age,history of abdominal surgery,coronary heart disease,viral hepatitis,anemia,surgical operation,digestive tract reconstruction,surgical resection,combined organ resection,tumor Site,tumor differentiation,tumor maximum diameter,cancerous ulcer area,number of lymph nodes,neutrophil lymphocyte ratio(NLR),platelets,CEA,CA19-9,N stage of tumor,total protein,Prealbumin,white blood cell count,body mass index(BMI)were not associated with the occurrence of duodenal fistula after gastric cancer surgery(P>0.05).3.Univariate analysis results can be obtained: cirrhosis,diabetes,hypertension,biliary inflammatory disease,operation time,intraoperative blood loss,tumor T stage,pathological stage(p TNM),low albumin(serum albumin <40g/L)was statistically significant(P<0.05)and was associated with the occurrence of duodenal fistula after gastric cancer surgery.Multivariate logistic regression analysis showed that cirrhosis,diabetes,biliary tract inflammation,operation time,and intraoperative blood loss were independent risk factors for duodenal stump fistula after gastric cancer surgery.Conclusion: Preoperative cirrhosis,diabetes,biliary tract inflammation,operation time and intraoperative blood loss are independent risk factors for duodenal stump fistula after gastric cancer surgery.Therefore,it is suitable for cirrhosis,diabetes and biliary tract before operation.Inflammatory patients should actively prevent the occurrence of postoperative duodenal fistula,shorten the operation time under the premise of stopping bleeding and ensuring the safety of surgery,which is beneficial to reduce the incidence of postoperative dsf in gastric cancer.