Risk factors for pancreatic fistula following pancreaticoduodenectomy: A retrospective study in a Thai tertiary center

被引：17

作者：

Rungsakulkij, Narongsak ^{[1
]}

Mingphruedhi, Somkit ^{[1
]}

Tangtawee, Pongsatorn ^{[1
]}

Krutsri, Chonlada ^{[1
]}

Muangkaew, Paramin ^{[1
]}

Suragul, Wikran ^{[1
]}

Tannaphai, Penampai ^{[2
]}

Aeesoa, Suraida ^{[1
]}

机构：

[1] Mahidol Univ, Ramathibodi Hosp, Fac Med, Dept Surg, 270 Praram 6 Rd, Bangkok 10400, Thailand

[2] Mahidol Univ, Ramathibodi Hosp, Fac Med, Dept Radiol, Bangkok 10400, Thailand

来源：

WORLD JOURNAL OF GASTROINTESTINAL SURGERY | 2017年 / 9卷 / 12期

关键词：

Risk factors; Pancreatic fistula; Pancreas; Pancreatectomy; Pancreaticoduodenectomy; PREOPERATIVE BILIARY DRAINAGE; INTERNATIONAL STUDY-GROUP; BODY-MASS INDEX; JAUNDICED PATIENTS; FATTY PANCREAS; METAANALYSIS; MULTICENTER; PREDICT; PANCREATICOJEJUNOSTOMY; PANCREATICOGASTROSTOMY;

D O I：

10.4240/wjgs.v9.i12.270

中图分类号：

R57 [消化系及腹部疾病];

学科分类号：

摘要：

AIM To analyze the risk factors of postoperative pancreatic fistula following pancreaticoduodenectomy in a Thai tertiary care center. METHODS We retrospectively analyzed 179 patients who underwent pancreaticoduodenectomy at our hospital from January 2001 to December 2016. Pancreatic fistula were classified into three categories according to a definition made by an International Study Group on Pancreatic Fistula. The risk factors for pancreatic fistula were analyzed by univariate analysis and multivariate logistic regression analysis. RESULTS Pancreatic fistula were detected in 88/179 patients (49%) who underwent pancreaticoduodenectomy. Fifty-eight pancreatic fistula (65.9%) were grade A, 22 cases (25.0%) were grade B and eight cases (9.1%) were grade C. Clinically relevant pancreatic fistula were detected in 30/179 patients (16.7%). The 30-d mortality rate was 1.67% (3/179 patients). Multivariate logistic regression analysis revealed that soft pancreatic texture (odds ratio = 3.598, 95% CI: 1.77-7.32) was the most significant risk factor for pancreatic fistula. A preoperative serum bilirubin level of > 3 mg/dL was the most significant risk factor for clinically relevant pancreatic fistula according to univariate and multivariate analysis. CONCLUSION Soft pancreatic tissue is the most significant risk factor for postoperative pancreatic fistula. A high preoperative serum bilirubin level (> 3 mg/dL) is the most significant risk factor for clinically relevant pancreatic fistula.

引用

页码：270 / 280

页数：11

共 41 条

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