Analysis Of Factors Associated With Pancreatic Fistula In Patients With Postoperative Gastric Cancer And Its Impact On Clinical Prognosis

Background and Aim:To investigate the correlation between the occurrence of postoperative grade A pancreatic fistula in postoperative patients with gastrointestinal tumors and various preoperative personal factors and postoperative laboratory indices;to conduct monofactor analyses of various stratified factors to identify risk factors for postoperative grade A pancreatic fistula,with a view to early clinical intervention.Methods:A retrospective study was taken to count 114 patients who underwent surgery for gastrointestinal tract tumors from 2020.06.01 to 2020.11.26.The types of surgery included total gastrectomy and distal gastrectomy for gastric cancer;radical surgery for right hemicolectomy;radical surgery for transverse colon cancer;and the surgical procedures covered traditional open surgery,laparoscopic surgery and da Vinci robotic surgery.The preoperative indicators involved in the statistics included patients’age,gender,BMI,whether they had neoadjuvant therapy,and the time of surgery.The postoperative indexes included the time of first venting,postoperative hospital days,WBC,CRP,and PCT on postoperative days 1 and 3.The diagnostic criteria for this grade A pancreatic fistula were defined as:abdominal drainage fluid amylase concentration higher than 3 times the upper limit of normal serum amylase.Results:A total of 37 postoperative complications occurred in this study,including 22 grade A pancreatic fistulas,5 incisional infections,2 bloodstream infections,4 gastrointestinal anastomotic fistulas,1 postoperative urinary tract infection,and 3 cases of bleeding,none of which showed a significant correlation.The following correlated with the amylase concentration in the abdominal drainage fluid(d-AMY1)on postoperative day 1:surgical approach(p=0.021),WBC1(p=0.022),WBC3(p=0.036);the following correlated with the amylase concentration in the abdominal drainage fluid(d-AMY3)on postoperative day 3:time of surgery(p=0.007);WBC1(p=0.028).CRP3(p=0.034);blood glucosel(p=0.023);and associated with the occurrence of postoperative grade A pancreatic fistula were:time to venting(p=0.045)PCT1(p=0.032).The rank sum test showed no significant relationship between octreotide use and the occurrence of postoperative grade A pancreatic fistula in patients undergoing gastric cancer surgery(p=0.075),whose main influencing factor was the duration of surgery greater than 300 minutes(p=0.014).Conclusions:There was no significant relationship between the application of octreotide and the occurrence of postoperative grade A pancreatic fistula in patients undergoing gastrointestinal surgery(p=0.075),and the main influencing factor was the duration of surgery>300 mins(p=0.014).And its cause should be the direct damage to the pancreatic tissue during surgery We surgeons should minimize the compressive damage to the pancreas and surrounding tissues during surgery in order to reduce the occurrence of postoperative pancreatic-related complications in patients.We hope that future prospective studies will develop a means to assess the risk of POPF by measuring the amount of amylase concentration in the patient’ s abdominal drainage fluid on postoperative days 1 and 3.